Jeanette Bates
Individual provider Active NPI Pharmacist · Milton, WV
NPI 1174079792 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1174079792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0008221 (WV)
- Practice address
- 16 Perry Morris SQ
Milton, WV 25541-1397 - Phone
- (304) 743-4880
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0008221 | WV | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0008221 | WV | Yes |
Addresses
Primary practice location
16 Perry Morris SQ
Milton, WV 25541-1397
Mailing address
7531 Winfield Rd
Winfield, WV 25213-7023
Phone (304) 410-2473
Other providers in Milton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.