Southern Tier Home Infusion Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022433 Issued in NY

Legal business name

SOUTHERN TIER HOME INFUSION INC

Practice address

863 Fairmount Ave
Jamestown, NY 14701-2521

Phone

(716) 484-1586

Fax

(716) 708-6248

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Richard Moon, PHARMDNPI 1699893446

Title

President

Phone

(167) 205-1217

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PHARMACY INNOVATIONS Doing business as

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard B Moon, PHARMD

  • Pharmacist
  • Jamestown, NY
  • NPI 1699893446
  NPD (past) Authorized official
• Gregory Scott Nelson, RPH

  • Pharmacist
  • Jamestown, NY
  • NPI 1538289947
  NPD (past)
• Michael Adam Schifano, PHARM D

  • Pharmacist
  • Jamestown, NY
  • NPI 1194958710
  NPD (past)
• Alison Burkholder, PHARMD

  • Pharmacist
  • Erie, PA
  • NPI 1003330804
  NPD (past)
• Taylor Scully

  • Pharmacist
  • Stoughton, MA
  • NPI 1104370485
  NPD (past)
• Kathryn Elisabeth Wilkosz, PHARMD

  • Pharmacist
  • Erie, PA
  • NPI 1770174914
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1295875730",
    "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": "863 FAIRMOUNT AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012521",
            "telephone_number": "716-484-1586",
            "fax_number": "716-708-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER HOME INFUSION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "167-205-1217",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "022433",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01423638",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2061686",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMACY INNOVATIONS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMACY INNOVATIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Soh, MD
• Carlie Jean Soldano, FNP-C
• Cain Forest Sonney, DPT
• Sevak Soukiazian, MD
• Olivia South
• Southern Tier Optometric Center Inc
• Southern Tier Optometry PLLC
• Southern Tier Optometry Vision Therapy
• Southern Tier Pediatrics Practice, P.C.
• Southside Pharmacy Inc

• Community/Retail Pharmacy in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.