Organization
WATERS PHARMACY INC
Active
Other names
BRISTOW PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WATERS (PRESIDENT)
(937) 392-4020
Entity
Organization
Contact information
Practice address
100 MAIN ST, RIPLEY, OH 45167-1232
(937) 392-4020
(937) 392-4078
Mailing address
100 MAIN ST, RIPLEY, OH 45167-1232
(937) 392-4020
(937) 392-4078
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
020976000
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460255
—
OH
01
—
2073985
PK
—
Enumeration date
08/10/2006
Last updated
05/26/2016
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