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General NPI Number Information
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NPI Number | 1205883394
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Entity Type | Organization
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Legal Business Name | STEWART'S PHARMACY, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 57 W MAIN ST
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City | AUSTIN
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State | IN
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Zip | 47102-1303
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Country | US
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Telephone | 812-794-3001
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Fax | 812-794-4007
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Provider Business Mailing Address
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Address Line | 57 W MAIN ST
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City | AUSTIN
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State | IN
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Zip | 47102-1303
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Country | US
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Telephone | 812-794-3001
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Fax | 812-794-4007
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. JEFFERY M. STEWART
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Credential | RPH
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Telephone | 812-794-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 60005878A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 60005878A
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License Number State | IN
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