Stewarts Pharmacy and the Wellness Store Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH16983 Issued in FL

Legal business name

STEWARTS PHARMACY AND THE WELLNESS STORE INC

Doing business as

Stewart's Pharmacy

Practice address

1350 E Mahan St Ste B-1
Tallahassee, FL 32308

Phone

(850) 216-1021

Fax

(850) 246-1042

NPI assigned

Feb 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracey Jackson

Title

Sect-Treas

Phone

(850) 216-1021

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stewart's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1932244886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E MAHAN ST STE B1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-216-1021",
            "fax_number": "850-246-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MAHAN ST STE B-1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-216-1021",
            "fax_number": "850-246-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWARTS PHARMACY AND THE WELLNESS STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "SECT-TREAS",
        "authorized_official_telephone_number": "850-216-1021"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "FL",
            "license": "PH16983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stewart's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lee Elliott Stewart
• Pamela Jayne Stewart, ARNP-C
• Robert Allen Stewart, MT-BC
• Robert Jackson Stewart
• Sarah Gabrielle Stewart
• Anna Stillman
• Carolyn Stimel, PH.D.
• Curtis Clarke Stine, MD
• Jennifer Stinson
• Brittany McKinney Stitely, M.ED. CCC-SLP

• Compounding Pharmacy in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.