Active NPI
Awalt-Stephenson Drug
Doing business as LTC Dynamics
- Long Term Care Pharmacy
- Fairfield, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- 26308
- Legal business name
- AWALT-STEPHENSON DRUG
- Doing business as
- LTC Dynamics
- Practice address
- 201 E Commerce St
Ste a
Fairfield, TX 75840-1509 - Phone
- (903) 389-2157
- Fax
- (903) 389-8939
- NPI assigned
- Feb 18, 2009
- Last updated
- Apr 12, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vance Oglesbee
- Title
- Pic
- Phone
- (903) 389-2157
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | 26308 | TX | Primary |
Addresses
Primary practice location
201 E Commerce St
Ste a
Fairfield, TX 75840-1509
Mailing address
201 E Commerce St
Ste a
Fairfield, TX 75840-1509
Phone (903) 389-2157
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2119068 | Other | PK |
Other names 1
- LTC Dynamics
National Provider Directory
National Provider Directory- Tax ID family
- Awalt-Stephenson Drug
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
201 E Commerce St
Ste A
Fairfield, TX 75840
Phone (903) 389-2157
Practitioners & affiliated clinicians
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.
-
- Pharmacist
- Fairfield, TX
- NPI 1942634704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1460419200000",
"number": "1386883171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E COMMERCE ST",
"address_2": "STE A",
"city": "FAIRFIELD",
"state": "TX",
"postal_code": "758401509",
"telephone_number": "903-389-2157",
"fax_number": "903-389-8939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E COMMERCE ST",
"address_2": "STE A",
"city": "FAIRFIELD",
"state": "TX",
"postal_code": "758401509",
"telephone_number": "903-389-2157",
"fax_number": "903-389-8939"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AWALT-STEPHENSON DRUG",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-18",
"last_updated": "2016-04-12",
"status": "A",
"authorized_official_last_name": "OGLESBEE",
"authorized_official_first_name": "VANCE",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "903-389-2157"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "TX",
"license": "26308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2119068",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LTC Dynamics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.