Etel Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ETEL PHARMACY

Doing business as

Etel Pharmacy

Practice address

2509 7TH St W
Saint Paul, MN 55116-2837

Phone

(651) 785-8280

Fax

(612) 440-2238

NPI assigned

Mar 3, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bishaw Ditamo, PHARMD

Title

Pharmacist in Charge/Pharmacist

Phone

(651) 414-9547

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Etel Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621728000000",
    "number": "1780279604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162837",
            "telephone_number": "651-785-8280",
            "fax_number": "612-440-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162837",
            "telephone_number": "651-785-8280",
            "fax_number": "612-440-2238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2509 7th St W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551162837",
            "country_code": "US",
            "telephone_number": "651-785-8280",
            "fax_number": "612-440-2238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3837 Heather Dr",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551221624",
            "country_code": "US",
            "telephone_number": "651-785-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ETEL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A",
        "authorized_official_last_name": "DITAMO",
        "authorized_official_first_name": "BISHAW",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE/PHARMACIST",
        "authorized_official_telephone_number": "651-414-9547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID NUMBER",
            "identifier": "7295476",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Etel Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Esters
• Antionette Renee Estis
• Christy Rowe Estlund, HIS
• Adalinda Estrada, M.A.
• Tenbit Etafa, LPCC
• Mary Joanne Ethen, LICSW
• Karisa Jean Etter, O.D.
• Jessica Marie Ettl, CRNA
• Ev Massage & Wellness LLC
• Brittany Lynn Evans-Hodgson, PA-C

• Community/Retail Pharmacy in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.