Healthcare Provider Details
I. General information
NPI: 1942219316
Provider Name (Legal Business Name): POINTCORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1505 EASTLAND DR
BLOOMINGTON IL
61701-3534
US
IV. Provider business mailing address
124 SW ADAMS ST
PEORIA IL
61602-1308
US
V. Phone/Fax
- Phone: 309-664-0505
- Fax: 309-661-0220
- Phone: 309-655-2850
- Fax: 309-655-4878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 054009629 |
| License Number State | IL |
VIII. Authorized Official
Name:
ROBERT
C
SEHRING
Title or Position: CEO
Credential:
Phone: 309-655-2850