Stephenson Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

25664 Issued in TX

Legal business name

STEPHENSON PHARMACY

Practice address

1000 S Fleishel Ave
Tyler, TX 75701-2037

Phone

(903) 593-0236

Fax

(903) 593-9375

NPI assigned

Aug 18, 2006

Last updated

Apr 29, 2009By 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

Patrick J Healy, R.PH.NPI 1033344924

Title

Owner

Phone

(903) 593-0236

Specialties & licenses 4

Addresses

Other identifiers 4

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.

• Patrick J Healy

  • Pharmacy
  • Tyler, TX
  • NPI 1033344924
  Authorized official Same address or phone

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1326152315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012037",
            "telephone_number": "903-593-0236",
            "fax_number": "903-593-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012037",
            "telephone_number": "903-593-0236",
            "fax_number": "903-593-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENSON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "HEALY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-593-0236",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "25664",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C08420064",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4552027",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010403601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4552027",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Alan Stephens, FNP-C
• Jeffrey James Stephens
• Michael S. Stephens, D.C.
• Renee Stephens
• Tina Stephens
• Stephenson Pharmacy, LLC
• Jack B Stephenson IV, M.D.
• Allison Sterken, LCSW
• Steve E Rowley DO PA (Long Term Care Associates)
• Steven G McCullough (Custom Care Orthopedic Bracing LLC)

• Pharmacy in Tyler, TX
• Providers in Tyler, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.