Ruth a Stewart

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46140 Issued in CA

Legal business name

RUTH A STEWART

Doing business as

Kelseyville Pharmacy

Practice address

3720 Main St
Kelseyville, CA 95451-7420

Phone

(707) 279-1561

Fax

(707) 279-1000

NPI assigned

Jul 24, 2006

Last updated

Apr 19, 2017By 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

Ruth Stewart, PHARMD

Title

Owner

Phone

(707) 279-1561

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• KELSEYVILLE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1881616472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954510727",
            "telephone_number": "707-279-1561",
            "fax_number": "707-279-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954517420",
            "telephone_number": "707-279-1561",
            "fax_number": "707-279-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTH A STEWART",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-279-1561",
        "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": "CA",
            "license": "PHY46140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1996034",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA461400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KELSEYVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Kelseyville, CA
• Providers in Kelseyville, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.