S. Fountain's Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

S. FOUNTAIN'S INC

Doing business as

dba The Medicine Shoppe #1189

Practice address

133 Newman St
East Tawas, MI 48730

Phone

(989) 362-7415

Fax

(989) 362-0597

NPI assigned

Mar 1, 2006

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. Steven Mark Fountain, R.PH.

Title

Owner/Pres

Phone

(989) 362-7415

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• dba The Medicine Shoppe #1189 Doing business as

Locations

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1477520377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 NEWMAN ST",
            "city": "EAST TAWAS",
            "state": "MI",
            "postal_code": "48730",
            "telephone_number": "989-362-7415",
            "fax_number": "989-362-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 NEWMAN ST",
            "city": "EAST TAWAS",
            "state": "MI",
            "postal_code": "48730",
            "telephone_number": "989-362-7415",
            "fax_number": "989-362-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. FOUNTAIN'S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PRES",
        "authorized_official_telephone_number": "989-362-7415",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2803794",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2803829",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2349517",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba The Medicine Shoppe #1189",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard P. Payea, M.D., PC
• Gretchen M Ross, BEHAVIOR TECHNICIAN
• Gloria Jean Rouleau-Gerber, LMSW CSW
• Crystal Angela Ruemenapp, O.D.
• Kristen Lois Runyan
• Kelly Sanderson, M.S., CCC-SLP
• Sarah Lynn Schalkofski
• Grace E Schlagel
• Julienne Schnettler, OTR/L
• Kayla Marie Schwiesow

• Community/Retail Pharmacy in East Tawas, MI
• Providers in East Tawas, MI by specialty
• Community/Retail Pharmacy in Michigan

• 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.