Organization
STEPHENSON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK J HEALY R.PH. (OWNER)
(903) 593-0236
Entity
Organization
Contact information
Practice address
1000 S FLEISHEL AVE, TYLER, TX 75701-2037
(903) 593-0236
(903) 593-9375
Mailing address
1000 S FLEISHEL AVE, TYLER, TX 75701-2037
(903) 593-0236
(903) 593-9375
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
25664
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010403601
—
TX
01
—
4552027
NABP
TX
01
—
4552027
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
C08420064
—
TX
Enumeration date
08/18/2006
Last updated
04/29/2009
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