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General NPI Number Information
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NPI Number | 1093876013
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Entity Type | Organization
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Legal Business Name | JENNINGS PHARMACY INC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1029 E MAIN ST
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City | OLNEY
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State | IL
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Zip | 62450-2625
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Country | US
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Telephone | 618-395-2144
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Fax | 618-392-5075
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Provider Business Mailing Address
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Address Line | 1029 E MAIN ST
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City | OLNEY
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State | IL
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Zip | 62450-2625
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Country | US
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Telephone | 618-395-2144
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Fax | 618-392-5075
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS LEE JENNINGS
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Credential | R.PH.
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Telephone | 618-395-2144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | IL
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