Stephens Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

006309 Issued in MO

Legal business name

STEPHENS PHARMACY INC

Doing business as

Stephens Pharmacy

Practice address

1100 S Springfield Ave
Bolivar, MO 65613-2512

Phone

(417) 326-2416

Fax

(417) 326-6625

NPI assigned

Aug 10, 2006

Last updated

Jun 22, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Micheal Stephens, RPH

Title

Pharmacy Owner

Phone

(417) 326-2416

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• STEPHENS PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1093726630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S SPRINGFIELD AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132512",
            "telephone_number": "417-326-2416",
            "fax_number": "417-326-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S SPRINGFIELD AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132512",
            "telephone_number": "417-326-2416",
            "fax_number": "417-326-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "PHARMACY OWNER",
        "authorized_official_telephone_number": "417-326-2416",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "006309",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049470",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620749002 DME",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600749006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEPHENS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sparks Pharmacy Inc (Bolivar Drug Compounding and Wellness)
• Sparks Pharmacy Inc (Bolivar Drug)
• Jeff Sparks
• John Richard Spooner, PSY.D.
• Cassie Stephans, PT
• Stephens Pharmacy Inc (Stephens Healthcare Services)
• Steven Bartholomew OD LLC
• Katelynn Stewart, LAT, ATC
• Jennifer Christine Stigers, PA-C
• Jamee M Stimpson, OT/L

• Community/Retail Pharmacy in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.