Healthcare Provider Details

I. General information

NPI: 1932245149
Provider Name (Legal Business Name): SCHOTTS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W BLUFF ST
MARSEILLES IL
61341-1342
US

IV. Provider business mailing address

800 W BLUFF ST
MARSEILLES IL
61341-1342
US

V. Phone/Fax

Practice location:
  • Phone: 815-795-2700
  • Fax: 815-795-2379
Mailing address:
  • Phone: 815-795-2700
  • Fax: 815-795-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054030433
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SELMA DZELIL
Title or Position: VICE PRESIDENT RDO
Credential: PHARMD.
Phone: 815-795-2700