Organization
STEPHENS PHARMACY INC
Active
Organization
STEPHENS PHARMACY INC
Active
Other names
Stephens Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STEPHENS (OWNER/PHARMACIST)
(417) 326-2416
Entity
Organization
Contact information
Practice address
1100 S SPRINGFIELD AVE STE A, BOLIVAR, MO 65613-2512
(417) 326-2570
Mailing address
1100 S SPRINGFIELD AVE, SUITE A, BOLIVAR, MO 65613-2512
(417) 326-2570
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
2011008719
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2639702
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/27/2011
Last updated
05/25/2011
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