Healthcare Provider Details

I. General information

NPI: 1962709154
Provider Name (Legal Business Name): EMMA J BELL R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 BLIZZARD RD
STILLWATER NY
12170-1412
US

IV. Provider business mailing address

68 BLIZZARD RD
STILLWATER NY
12170-1412
US

V. Phone/Fax

Practice location:
  • Phone: 518-378-3424
  • Fax:
Mailing address:
  • Phone: 518-378-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040632
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number040632
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: