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General NPI Number Information
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NPI Number | 1003976119
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Entity Type | Organization
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Legal Business Name | STEPHENS PHARMACY INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 2600 15TH STREET RD
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City | HUEYTOWN
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State | AL
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Zip | 35023-3606
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Country | US
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Telephone | 205-425-4592
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Fax | 205-425-0701
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Provider Business Mailing Address
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Address Line | 2600 15TH STREET RD
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City | HUEYTOWN
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State | AL
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Zip | 35023-3606
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Country | US
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Telephone | 205-425-4592
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Fax | 205-425-0701
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Authorized Official
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Title or Position | PRESIDENT
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Name | SPENCER STEPHENS
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Credential |
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Telephone | 205-408-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 106970
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License Number State | AL
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