Bobbie Stephens, PST.024041
Individual provider Active NPI Pharmacist · Lake Providence, LA
NPI 1932861853 · NPPES record last updated Oct 7, 2021
Key facts
- NPI
- 1932861853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PST.024041 (LA)
- Practice address
- 302 Lake Street
Lake Providence, LA 71254-7125 - Phone
- (318) 559-2433
- NPI assigned
- Oct 7, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.024041 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SCPG Louisiana LLC | Current |
Accepting new patients |
Locations
302 Lake St
Lake Providence, LA 71254
Phone (318) 559-2433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.024041 | LA | Yes |
Addresses
Primary practice location
302 Lake Street
Lake Providence, LA 71254-7125
Mailing address
9702 Highway 585
Oak Grove, LA 71263-8222
Phone (318) 669-0740
Other providers in Lake Providence, LA
- Antrameka W Shaw
- Brittany Nicole Shelton
- Wanda Shoemaker
- Llewellyn Simon
- Star Clipper Transfers LLC
- Ronald C Stratton Jr.
- Allison C Tatum
- Chandra S Thompson
- Renada Corletha Thompson
- Amanda Thornton
All providers in Lake Providence, LA · Pharmacist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.