Provider Demographics
NPI:1114238946
Name:BOTES, ESTELLE
Entity Type:Individual
Prefix:MRS
First Name:ESTELLE
Middle Name:
Last Name:BOTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2031
Mailing Address - Country:US
Mailing Address - Phone:610-664-4010
Mailing Address - Fax:610-664-0613
Practice Address - Street 1:640 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2031
Practice Address - Country:US
Practice Address - Phone:610-664-4010
Practice Address - Fax:610-664-0613
Is Sole Proprietor?:No
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist