Healthcare Provider Details

I. General information

NPI: 1730246158
Provider Name (Legal Business Name): FELKER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LANDMARK DR
WINNEBAGO IL
61088-7702
US

IV. Provider business mailing address

PO BOX 427
WINNEBAGO IL
61088-0427
US

V. Phone/Fax

Practice location:
  • Phone: 815-335-3535
  • Fax: 815-335-1186
Mailing address:
  • Phone: 815-335-3535
  • Fax: 815-335-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54014421
License Number StateIL

VIII. Authorized Official

Name: THOMAS FELKER
Title or Position: OWNER
Credential:
Phone: 815-765-1300