Healthcare Provider Details

I. General information

NPI: 1194700203
Provider Name (Legal Business Name): BEST BUY PHARMACY OF PITTSFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 W WASHINGTON ST
PITTSFIELD IL
62363-1654
US

IV. Provider business mailing address

PO BOX 463
PITTSFIELD IL
62363-0463
US

V. Phone/Fax

Practice location:
  • Phone: 217-285-5515
  • Fax: 217-285-1326
Mailing address:
  • Phone: 217-285-5515
  • Fax: 217-285-1326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateIL

VIII. Authorized Official

Name: ERICA DAWN THOMAS
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMACIST
Phone: 217-285-5515