Organization
SOUTHERN TIER HOME INFUSION INC
Active
Other names
PHARMACY INNOVATIONS
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MOON PHARMD (OWNER)
(716) 720-5121
Entity
Organization
Contact information
Practice address
2936 W 17TH ST, ERIE, PA 16505-3929
(814) 838-2102
(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
PP481320
PA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036178670001
—
PA
01
—
2086805
PK
—
Enumeration date
04/25/2007
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