# STEVENS-HOWELL VENTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Howell Health Mart Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538418546
- **Authorized official:** CLAYTON STEVENS PHARMD (MANAGER)
- **Authorized official phone:** (618) 781-3985

## Contact information

- **Practice address:** 447 S BUCHANAN ST, EDWARDSVILLE, IL 62025-2064
- **Practice address phone:** (618) 655-0106
- **Practice address fax:** (618) 655-0206
- **Mailing address:** 447 S BUCHANAN ST, EDWARDSVILLE, IL 62025-2064
- **Mailing address phone:** (618) 655-0106
- **Mailing address fax:** (618) 655-0206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054.018073 | IL | Yes |

## Other

- **Enumeration date:** 09/05/2012
- **Last updated:** 01/09/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1487342 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |