Eric Rolwing
Individual provider Active NPI Pharmacist · Charleston, MO
NPI 1285188656 · NPPES record last updated Aug 15, 2016
Key facts
- NPI
- 1285188656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2016027740 (MO)
- Practice address
- 406 S Main St
Charleston, MO 63834-1644 - Phone
- (573) 683-3307
- NPI assigned
- Aug 15, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 2016027740 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan & Seiler Inc | Past | Accepting new patients | |
| Logan & Seiler Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2016027740 | MO | Yes |
Addresses
Primary practice location
406 S Main St
Charleston, MO 63834-1644
Mailing address
839 N 219TH Rd
Charleston, MO 63834-9243
Other providers in Charleston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 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.