Southern Tier Infusion Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SOUTHERN TIER INFUSION INC

Doing business as

Pharmacy Innovations

Practice address

8687 Louetta Rd Ste 150
Spring, TX 77379-6672

Phone

(281) 251-0888

Fax

(716) 708-6248

NPI assigned

Jan 26, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard B Moon, PHARMD

Title

Owner Pharmacist

Phone

(716) 720-5121

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Pharmacy Innovations Doing business as

Tax ID family

Pharmacy Innovations3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Tier Home Infusion Inc

  dba Pharmacy Innovations

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1891940391
  NPD tax ID
• Southern Tier Home Infusion Inc

  dba Pharmacy Innovations

  • Community/Retail Pharmacy
  • Erie, PA
  • NPI 1629297718
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina M Tong, RPH

  • Pharmacist
  • Spring, TX
  • NPI 1689246852
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1245386689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 JOHNS PL",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019210",
            "telephone_number": "716-720-5121",
            "fax_number": "716-708-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8687 LOUETTA RD STE 150",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796672",
            "telephone_number": "281-251-0888",
            "fax_number": "716-708-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER INFUSION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-03-07",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "716-720-5121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "90154967",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148107",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE",
            "identifier": "25732",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy Innovations",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pharmacy Innovations",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Spring, TX
• Providers in Spring, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.