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General NPI Number Information
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NPI Number | 1306156963
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Entity Type | Organization
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Legal Business Name | B Y ENTERPRISES INC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 808 HUNTER AVE STE 1A
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City | SIKESTON
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State | MO
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Zip | 63801-2253
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Country | US
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Telephone | 573-475-1900
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Fax | 573-472-1814
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Provider Business Mailing Address
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Address Line | PO BOX 886
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City | SIKESTON
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State | MO
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Zip | 63801-0886
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Country | US
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Telephone | 573-475-1900
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Fax | 573-472-1814
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ROSS MERIDETH
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Credential | PHARM D
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Telephone | 573-472-0608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2010034498
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License Number State | MO
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