Provider Demographics
NPI:1902931868
Name:BKO STEPHENS INC.
Entity Type:Organization
Organization Name:BKO STEPHENS INC.
Other - Org Name:STEPHENS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:G
Authorized Official - Last Name:UPCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:423-447-2434
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367
Mailing Address - Country:US
Mailing Address - Phone:423-447-2434
Mailing Address - Fax:423-447-6151
Practice Address - Street 1:3135 MAIN ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367
Practice Address - Country:US
Practice Address - Phone:423-447-2434
Practice Address - Fax:423-447-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5468200001Medicare NSC