Provider Demographics
NPI:1801815881
Name:STEPHENS, JAMES (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-1307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 E DAKOTA AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3198
Practice Address - Country:US
Practice Address - Phone:605-224-0907
Practice Address - Fax:605-224-8027
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist