Stanley Akimbom, PHARMACIST
Individual provider Active NPI Pharmacist · The Colony, TX
NPI 1609439223 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1609439223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PST.022913 (LA)
- Practice address
- 6749 Main St
The Colony, TX 75056-1647 - Phone
- (972) 625-3207
- NPI assigned
- Apr 18, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64031 | TX | MD | Clinical Social Worker |
| PST.022913 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.022913 | LA | Yes |
| Pharmacist | 183500000X | 64031 | TX |
Addresses
Primary practice location
6749 Main St
The Colony, TX 75056-1647
Mailing address
1100 Rutherford St
Frisco, TX 75036-0957
Phone (262) 753-3871
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | str.05181@walgreens.com | Direct |
Other providers in The Colony, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.