Bates, Stacy Louiseb
Bates, Stacy Louiseb is an sole proprietor health care provider with primary practice located at 6390 Brooklyn Blvd , Brooklyn Center MN 55429-2600. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Bates, Stacy Louiseb can be contacted via phone (763) 585-9946.Contact Information
Primary practice address
6390 Brooklyn Blvd
Brooklyn Center MN 55429-2600
Phone: (763) 585-9946
Fax: (763) 569-9904
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 119993 | Minnesota |
Profile Details
| NPI number | 1578849535 |
|---|---|
| LBN Legal business name | Bates, Stacy Louiseb |
| Credentials | PHARMD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 21st, 2011 |
| Last updated | Oct 21st, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578849535 | NPPES |
| Minnesota | MEDICAID | 2422323 |
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