Healthcare Provider Details
I. General information
NPI: 1104817048
Provider Name (Legal Business Name): ANTHONY LEE ESKER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 10/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 E BROADWAY
STEELEVILLE IL
62288-1733
US
IV. Provider business mailing address
324 W BROADWAY
STEELEVILLE IL
62288-1407
US
V. Phone/Fax
- Phone: 618-965-9180
- Fax:
- Phone: 618-965-3511
- Fax: 618-965-3553
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: