# STEVENS PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** STEVENS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295890622
- **Authorized official:** STEVEN GOUGH (PRESIDENT)
- **Authorized official phone:** (225) 336-4456

## Contact information

- **Practice address:** 520 S ALEXANDER AVE, STE 200, PORT ALLEN, LA 70767-3100
- **Practice address phone:** (225) 336-4456
- **Practice address fax:** (225) 336-4458
- **Mailing address:** 520 S ALEXANDER AVE, STE 200, PORT ALLEN, LA 70767-3100
- **Mailing address phone:** (225) 336-4456
- **Mailing address fax:** (225) 336-4458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY004535IR | LA | Yes |

## Other

- **Enumeration date:** 12/26/2006
- **Last updated:** 06/16/2014