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STONEGATE PHARMACY ON BROADWAY
NPI 1376564310
Pharmacy - Community/Retail Pharmacy in San Antonio, TX

Active since July 23, 2006CLIA 45D1073188 · Waiver
2515 BROADWAY ST, SAN ANTONIO, TX 78215(210) 354-0101(210) 354-0404 Get Directions Write a Review

NPPES record last updated: September 6, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 18, 2016, Jan 20, 2016, Dec 22, 2015 (3 updates tracked since 2015).

About Stonegate Pharmacy On Broadway NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STONEGATE PHARMACY ON BROADWAY (NPI 1376564310) is a healthcare organization registered as a community/retail pharmacy in San Antonio, Texas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 6, 2028 and lists Jessica Ruiz, Controller, as its authorized official.

NPPES Registry Identity

NPI1376564310
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMARIOS PHARMACY INC
Location Address2515 BROADWAY STSan Antonio, TX 78215-1037
Mailing Address2501 W William Cannon Dr, Ste. 203Austin, TX 78745-5281 · (512) 707-2300
Phone(210) 354-0101
Fax(210) 354-0404
Organization SubpartNo
Authorized OfficialJessica RuizController · (210) 913-2244
Enumeration DateJuly 23, 2006
Last NPPES UpdateSeptember 6, 20173 updates tracked since enumeration
✔ NPI 1376564310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 24112
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
2515 BROADWAY ST, San Antonio, TX 78215
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Other Names 1

Doing Business AsStonegate Pharmacy On Broadway

Other Identifiers 2

Medicaid145542TX
Other2097195Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., AvMed, Blue Cross and Blue Shield of Kansas City and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1073188

Stonegate Pharmacy · Austin, TX
Active · expires Apr 6, 2028
CLIA Number45D1073188
Laboratory TypePharmacy
Certificate Effective DateApril 7, 2026
Certificate Expiration DateApril 6, 2028
Laboratory DirectorRene F. Garza
Laboratory Phone(512) 707-2300
Laboratory LocationStonegate Pharmacy2501 W William Cannon 203, Austin, TX 78745
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CESAR TREVINO PHARMD
Pharmacist
2515 BROADWAY ST
SAN ANTONIO, TX 78215
Bexar County (210) 354-0101
KIERSTEN BRAASCH PHARMD
Pharmacist
2515 BROADWAY ST
SAN ANTONIO, TX 78215
Bexar County (210) 354-0101
JANET THONGKAM RPH
Pharmacist
2515 BROADWAY ST
SAN ANTONIO, TX 78215
Bexar County (210) 354-0101
MR. MARIO JESUS DE LOS SANTOS JR.
Pharmacist
2515 BROADWAY ST
SAN ANTONIO, TX 78215
Bexar County (210) 354-0101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marios Pharmacy Inc's NPI number?

The NPI number for Marios Pharmacy Inc is 1376564310. It was assigned to this organization in the NPPES registry on July 23, 2006. The provider is doing business as Stonegate Pharmacy On Broadway.

Where is Marios Pharmacy Inc located?

Marios Pharmacy Inc is located at 2515 Broadway St, San Antonio, TX 78215. The listed phone number is (210) 354-0101.

What is Marios Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Marios Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1073188) is associated with this NPI, valid through April 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Marios Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., AvMed, Blue Cross Blue Shield of North Dakota, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Kansas City and 16 other insurers list Marios Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marios Pharmacy Inc was last updated on September 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.