Healthcare Provider Details

I. General information

NPI: 1750360509
Provider Name (Legal Business Name): JAMES DEWEY STEPHENS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7357 E GOODALL RD
DURAND MI
48429-9732
US

IV. Provider business mailing address

7357 E GOODALL RD
DURAND MI
48429-9732
US

V. Phone/Fax

Practice location:
  • Phone: 989-277-7127
  • Fax:
Mailing address:
  • Phone: 989-277-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302022066
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: