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NPI Code Detail

MEDICARE: ESTM INC

MEDICARE: ESTM INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care Pharmacy
23336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1528457728
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESTM INC
Provider Business Mailing Address
First Line : 107 ERICA DR
Second Line :
City : RICHLAND
State : WA
Zip : 99352-8463
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 133 N ELY ST STE C1
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-2941
Country : US
Telephone Number : 509-545-0596
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : ESLAM MOHAMED
Credential :
Telephone Number : 509-545-0596
Provider Enumeration Date : 01/12/2015
Last Update Date : 09/15/2015

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Directions to “ESTM INC ” Practice Location

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