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General NPI Number Information
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NPI Number | 1063976033
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Entity Type | Organization
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Legal Business Name | VOGEL'S COMPOUNDING PHARMACY PLLC
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 137 NORTH MARKET STREET
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City | PAXTON
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State | IL
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Zip | 60957
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Country | US
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Telephone | 217-781-0901
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Fax |
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Provider Business Mailing Address
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Address Line | 137 NORTH MARKET STREET
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City | PAXTON
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State | IL
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Zip | 60957
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Country | US
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Telephone | 217-781-0901
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JENNA VOGEL
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Credential | RPH
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Telephone | 217-781-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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