Provider Demographics
NPI:1497832216
Name:ERNEST CHARLES & COMPANY
Entity Type:Organization
Organization Name:ERNEST CHARLES & COMPANY
Other - Org Name:MITOWNE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSW
Authorized Official - Phone:478-757-9909
Mailing Address - Street 1:3638 VINEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1853
Mailing Address - Country:US
Mailing Address - Phone:478-757-9909
Mailing Address - Fax:478-757-0195
Practice Address - Street 1:3638 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1853
Practice Address - Country:US
Practice Address - Phone:478-757-9909
Practice Address - Fax:478-757-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies