Healthcare Provider Details

I. General information

NPI: 1598185423
Provider Name (Legal Business Name): BARBARA BATES PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7102 E BIG MEADOWS RD
CHATTAROY WA
99003-8500
US

IV. Provider business mailing address

7102 E BIG MEADOWS RD
CHATTAROY WA
99003-8500
US

V. Phone/Fax

Practice location:
  • Phone: 509-238-2468
  • Fax:
Mailing address:
  • Phone: 509-238-2468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00011327
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: