E & S Pharmacy Inc

Organization Active NPI Durable Medical Equipment & Medical Supplies · Doniphan, MO

NPI 1609911643 · NPPES record last updated Aug 1, 2012

Key facts

NPI
1609911643
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
004301 (MO)
Legal business name
E & S PHARMACY INC
Practice address
1105 Walnut St
Doniphan, MO 63935-1339
Phone
(573) 996-7157
Fax
(573) 996-7526
NPI assigned
Feb 20, 2007
Organization subpart
No

Authorized official

Name
Mrs. Sandra J Bates, R.PH.
Title
Pharmacist
Phone
(573) 996-7157

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930012624 MO DME Supplier - Pharmacy
DME Supplier - Oxygen & Equipment
4385761857 Practice locations: Doniphan, MO

National Provider Directory

Tax ID family
E S Pharmacy Inc (2 organizations share this tax ID)

Locations

1105 Walnut St
Doniphan, MO 63935
Phone (573) 996-7157

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 004301 MO Yes

Addresses

Primary practice location

1105 Walnut St
Doniphan, MO 63935-1339

Mailing address

1105 Walnut St
Doniphan, MO 63935-1339
Phone (573) 996-7157

Other identifiers

IdentifierTypeStateIssuer
622040004MedicaidMO

Other providers in Doniphan, MO

All providers in Doniphan, MO · Durable Medical Equipment & Medical Supplies in Missouri

Sources for this page

Verify at the official NPI Registry.