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
Fax: (763) 569-9904
Website:

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578849535 NPPES
Minnesota MEDICAID 2422323

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