Organization
ERNEST & SUSAN L ROALES
Active
Other names
SCOTTS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST ROALES RPH (OWNER)
(618) 945-3701
Entity
Organization
Contact information
Practice address
208 N MAIN ST, BRIDGEPORT, IL 62417-1522
(618) 945-3701
(618) 945-3701
Mailing address
PO BOX 75, BRIDGEPORT, IL 62417-0075
(618) 945-3701
(618) 945-9382
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054008755
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018808
PK
—
Enumeration date
05/31/2005
Last updated
02/21/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us