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General NPI Number Information
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NPI Number | 1609911643
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Entity Type | Organization
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Legal Business Name | E & S PHARMACY INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 1105 WALNUT ST
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City | DONIPHAN
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State | MO
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Zip | 63935-1339
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Country | US
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Telephone | 573-996-7157
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Fax | 573-996-7526
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Provider Business Mailing Address
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Address Line | 1105 WALNUT ST
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City | DONIPHAN
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State | MO
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Zip | 63935-1339
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Country | US
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Telephone | 573-996-7157
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Fax | 573-996-7526
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. SANDRA J BATES
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Credential | R.PH.
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Telephone | 573-996-7157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 004301
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License Number State | MO
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