Healthcare Provider Details

I. General information

NPI: 1285699959
Provider Name (Legal Business Name): STAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8691 N MARCUS ST
WRIGHTSVILLE GA
31096-2025
US

IV. Provider business mailing address

PO BOX 488
WRIGHTSVILLE GA
31096-0488
US

V. Phone/Fax

Practice location:
  • Phone: 478-864-2217
  • Fax: 478-864-1985
Mailing address:
  • Phone: 478-864-2217
  • Fax: 478-864-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE010131
License Number StateGA

VIII. Authorized Official

Name: STEPHENIE RAGAN
Title or Position: PARTNER
Credential:
Phone: 478-864-2217