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Ernest & Susan L Roales
Compounding Pharmacy in Bridgeport, Illinois
NPI 1346243672

Ernest & Susan L Roales is a Compounding Pharmacy based in Bridgeport, IL and is specialized in Compounding Pharmacy. Ernest & Susan L Roales practices in Bridgeport, IL. The NPI Number for Ernest & Susan L Roales is 1346243672 and holds a License No. (Illinois).

The current practice location address for Ernest & Susan L Roales is 208 N Main St, Bridgeport, IL and can be reached out via phone at 618-945-3701 and via fax at 618-945-3701.

Location: 208 N Main St, Bridgeport, IL, 62417-0075
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346243672
Provider Name
Ernest & Susan L Roales
Credential
Provider Entity Type
Organization
Address
208 N Main St, Bridgeport, IL, 62417-0075
Phone Number
618-945-3701
Fax Number
618-945-3701
Provider Enumeration Date
05/31/2005
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2018808 01 PK
institution
Provider Business Practice Location Address Details
Address
208 N Main St
City
Bridgeport
State
Illinois
Zip
62417-1522
Phone Number
618-945-3701
Fax Number
618-945-3701
person
Provider Business Mailing Address Details
Address
208 N Main St
City
Bridgeport
State
Illinois
Zip
62417-1522
Phone Number
618-945-3701
Fax Number
618-945-3701
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
054008755 (Illinois)
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Compounding Pharmacy
Taxonomy
3336C0004X
License No.
()
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
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