ERNEST & SUSAN L ROALES (NPI# 1346243672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346243672 |
| Entity Type | Organization |
| Organization Name | ERNEST & SUSAN L ROALES |
| Other Organization Name | SCOTTS DRUGS |
| Practice Address |
208 N Main St Bridgeport IL 62417-1522 |
| Mailing Address |
Po Box 75 Bridgeport IL 62417-0075 |
| Practice Telephone | 6189453701 |
| Practice Fax Number | 6189453701 |
| Mailing Telephone | 6189453701 |
| Mailing Fax Number | 6189459382 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2017-02-21 |
| Authorized Official Name | ERNEST ROALES (OWNER) |
| Authorized Official Telephone | 6189453701 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054008755 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2018808 | 01 |
| Other Name | Type Code |
|---|---|
| SCOTTS DRUGS | Doing Business As Name - Organization |
| Street Address |
208 N MAIN ST |
| City | BRIDGEPORT |
| State | IL |
| Zip Code | 62417-1522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053810390 | Ernest Paul Roales | Pharmacist | 208 N Main St, Bridgeport, IL 62417-1522 | 2018-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740375229 | Red Hill Cu School Dist 10 | Local Education Agency (LEA) | 1250 Judy Ave, Bridgeport, IL 62417 | 2006-10-03 |
| 1922514082 | Tricia Rae Inyart | Speech-Language Pathologist | 1300 N Main St, Bridgeport, IL 62417-1300 | 2017-12-26 |
| 1871677005 | Albert W Lewis | Ambulance | 1305 Ash St, Bridgeport, IL 62417-1707 | 2006-10-24 |
| 1144643354 | Aperion Care Bridgeport LLC | Durable Medical Equipment & Medical Supplies | 900 Corporation St, Bridgeport, IL 62417-2206 | 2014-01-23 |
| 1184613515 | Lawrence Community Healthcare Center Inc | Skilled Nursing Facility | 900 Corporation Line St, Bridgeport, IL 62417-2206 | 2005-10-18 |
| 1760033492 | Aperion Care Bridgeport LLC | Durable Medical Equipment & Medical Supplies | 900 Corporation St, Bridgeport, IL 62417-2206 | 2019-09-24 |
| 1366694317 | Lawrence Community Healthcare Center | Durable Medical Equipment & Medical Supplies | 900 Corporation Line St, Bridgeport, IL 62417-2206 | 2008-10-21 |
| 1801048855 | Lawrence Community Healthcare | Private Vehicle | 900 Corporation Line St, Bridgeport, IL 62417-2206 | 2008-10-21 |
| 1760973424 | Amelia L Pauley | Registered Nurse | 101 Industry Rd, Bridgeport, IL 62417-2442 | 2018-05-29 |
| 1124673256 | Gretchen Ginder | Family Medicine | 101 Industry Rd, Bridgeport, IL 62417-2442 | 2019-08-06 |
| Find all providers in zip 62417 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
| 1609432459 | Brx LLC | Pharmacy | 319 S Virginia Ave, Bridgeport, WV 26330-1744 | 2019-05-17 |
| 1871027714 | Unity Pharmacy II LLC | Pharmacy | 679 Fairfield Ave, Bridgeport, CT 06604-3906 | 2017-04-18 |
| 1063960755 | Workers First Pharmacy Services LLC | Pharmacy | 207 W 4th St Ste B, Bridgeport, PA 19405-1012 | 2016-09-12 |
| 1265809420 | Ls Health, LLC | Pharmacy | 54 W 4th St, Suite 38, Bridgeport, PA 19405-1009 | 2015-08-24 |
| 1548673940 | Hope Dispensary of Greater Bridgeport | Pharmacy | 752 E Main St # 170, Bridgeport Dept of Health, Bridgeport, CT 06608-2335 | 2014-06-04 |
| 1538445101 | Mountaineer Medical Office Building Pharmacy | Pharmacy | 120 Medical Park Dr Ste 102, Bridgeport, WV 26330-9013 | 2011-10-27 |
| 1093094021 | Right Care Pharmacy Inc | Pharmacy | 2366 Main St, Bridgeport, CT 06606-5339 | 2011-08-09 |
| 1710287602 | Brookshire Grocery Company | Pharmacy | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2010-10-26 |
| 1699879510 | Connecticut Cvs Pharmacy, L.L.C. | Pharmacy | 3710 Main St, Bridgeport, CT 06606-3613 | 2006-09-12 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 62417 |
Please comment or provide details below to improve the information on ERNEST & SUSAN L ROALES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.