Provider Demographics
NPI:1093027393
Name:STONEY'S PHARMACY PLC
Entity Type:Organization
Organization Name:STONEY'S PHARMACY PLC
Other - Org Name:CLINICAL COMPOUND PHARMACY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:LAPORTE
Authorized Official - Last Name:STONEBURNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:239-331-3441
Mailing Address - Street 1:2616 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4409
Mailing Address - Country:US
Mailing Address - Phone:239-331-3441
Mailing Address - Fax:239-331-3445
Practice Address - Street 1:2616 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4409
Practice Address - Country:US
Practice Address - Phone:239-331-3441
Practice Address - Fax:239-331-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-02
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH24645183500000X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0004XSuppliersPharmacyCompounding PharmacyGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH24645OtherSTATE LICENSE NUMBER