Stevens Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY004535IR Issued in LA

Legal business name

STEVENS PHARMACY INC

Doing business as

Stevens Pharmacy

Practice address

520 S Alexander Ave
Ste 200
Port Allen, LA 70767-3100

Phone

(225) 336-4456

Fax

(225) 336-4458

NPI assigned

Dec 26, 2006

Last updated

Jun 16, 2014By 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

Steven Gough

Title

President

Phone

(225) 336-4456

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• STEVENS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1295890622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S ALEXANDER AVE",
            "address_2": "STE 200",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707673100",
            "telephone_number": "225-336-4456",
            "fax_number": "225-336-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S ALEXANDER AVE",
            "address_2": "STE 200",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707673100",
            "telephone_number": "225-336-4456",
            "fax_number": "225-336-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "GOUGH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-336-4456"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY004535IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268194",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2034893",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEVENS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Port Allen, LA
• Providers in Port Allen, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.