Organization
SOUTHERN TIER HOME INFUSION INC
Active
Other names
PHARMACY INNOVATIONS
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MOON PHARMD (PRESIDENT)
(167) 205-1217
Entity
Organization
Contact information
Practice address
863 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2521
(716) 484-1586
(716) 708-6248
Mailing address
2535 JOHNS PL, JAMESTOWN, NY 14701-9210
(716) 720-5121
(716) 708-6248
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022433
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01423638
—
NY
01
—
2061686
PK
—
Enumeration date
02/07/2007
Last updated
07/13/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us