Ernest & Susan L Roales

NPI 1346243672 - Pharmacy - 333600000X

NPI Details
NPI 1346243672
Enumeration Date 05/31/2005
Last Updated 03/29/2014
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name ERNEST ERNEST
Position OWNER
Phone (618) 945-3701
Fax (618) 945-3701
Practice Location
208 N MAIN ST
BRIDGEPORT IL, 62417-1522, US
Phone (618) 945-3701
Fax (618) 945-3701
Business Location
PO BOX 75
BRIDGEPORT IL, 62417-0075, US
Phone
Fax
Toxanomy
Taxonomy Code 333600000X
License State
License Number
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According to our database, Ernest & Susan L Roales NPI is 1346243672, taxonomy code is 333600000X Ernest & Susan L Roales physically located at 208 N Main St, Bridgeport IL, 62417-1522. NPI Number 1033115704 has the healthcare provider type.

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1346243672 NPI number is provided on an as is basis without warranty of any kind. 1346243672 is maintained by the National Plan & Provider Enumeration System. The contents of Ernest & Susan L Roales are for informational purposes only.