Stephens Health Care Specialists PLLC

Organization Active NPI Community/Retail Pharmacy · Cheyenne, OK

NPI 1366765638 · NPPES record last updated Feb 28, 2017

Key facts

NPI
1366765638
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
76-5469 (OK)
Legal business name
STEPHENS HEALTH CARE SPECIALISTS PLLC
Practice address
413 Broadway
Cheyenne, OK 73628
Phone
(580) 497-3325
Fax
(580) 497-3326
NPI assigned
Mar 1, 2010
Organization subpart
No

Authorized official

Name
Jaclyn Stephens
Title
Owner / Pic
Phone
(580) 497-3325

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Cheyenne Professional Drug (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 76-5469 OK Yes

Addresses

Primary practice location

413 Broadway
Cheyenne, OK 73628

Mailing address

PO Box 860
Cheyenne, OK 73628-0860
Phone (580) 497-3325

Other identifiers

IdentifierTypeStateIssuer
2123708OtherPK
200263180AMedicaidOK

Other names

  • CHEYENNE PROFESSIONAL DRUG Doing business as

Other providers in Cheyenne, OK

All providers in Cheyenne, OK · Community/Retail Pharmacy in Oklahoma

Sources for this page

Verify at the official NPI Registry.