Long, Tabetha M

Long, Tabetha M is an individual health care provider with primary practice located at 3400 Green Mount Crossing Dr T-1539, Shiloh IL 62269-7277. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Long, Tabetha M can be contacted via phone (618) 628-3334.

Contact Information

Primary practice address
3400 Green Mount Crossing Dr T-1539 Shiloh IL 62269-7277
Phone: (618) 628-3334
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 051.290201 Illinois
Pharmacy Service Providers / Pharmacist 183500000X 2011011784 Missouri

Profile Details

NPI number 1659665842
LBN Legal business name Long, Tabetha M
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2011
Last updated Jun 5th, 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.

Request for update

Popular Providers