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General NPI Number Information
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NPI Number | 1346674280
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Entity Type | Organization
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Legal Business Name | INDEPENDENCE HOLDING CO LLC
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Dates
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Enumeration Date | 08/28/2013
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 14 E WASHINGTON ST STE C
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City | CHAMPAIGN
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State | IL
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Zip | 61820-3677
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Country | US
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Telephone | 217-355-6607
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Fax | 217-355-6639
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Provider Business Mailing Address
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Address Line | 14 E WASHINGTON ST STE C
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City | CHAMPAIGN
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State | IL
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Zip | 61820-3677
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Country | US
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Telephone | 217-355-6607
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Fax | 217-355-6639
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Authorized Official
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Title or Position | PHARMACIST
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Name | BRUCE A STRIKE
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Credential |
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Telephone | 217-355-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 054018086
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License Number State | IL
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