Ernest & Susan L Roales
NPI #1346243672 in Bridgeport, Illinois
Provider Information
- NPI Number
- 1346243672
- Entity Type
- Organization
- Organization Name
- Ernest & Susan L Roales
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 31, 2005
- Last Updated
- Feb 21, 2017
Practice Location
- Address
- 208 N MAIN ST
- City
- Bridgeport
- State
- Illinois
- ZIP Code
- 62417-1522
- Phone
- (618) 945-3701
Authorized Official
- Name
- ERNEST ROALES, RPH
- Title
- OWNER
- Phone
- (618) 945-3701
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Compounding Pharmacy — Compounding Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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