Provider Demographics
NPI:1619981693
Name:B Y ENTERPRISES INC
Entity Type:Organization
Organization Name:B Y ENTERPRISES INC
Other - Org Name:STERLING HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:MERIDETH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:573-472-0608
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-0886
Mailing Address - Country:US
Mailing Address - Phone:573-472-0608
Mailing Address - Fax:573-472-1814
Practice Address - Street 1:808 HUNTER AVE
Practice Address - Street 2:STE 1
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-2248
Practice Address - Country:US
Practice Address - Phone:573-472-0608
Practice Address - Fax:573-472-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY005892333600000X
MO57413336L0003X
AROS013473336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2047189OtherPK
AR135542407Medicaid
MO607804804Medicaid