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General NPI Number Information
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NPI Number | 1356488183
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Entity Type | Organization
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Legal Business Name | THROGMORTON POWLESS PHARMACY INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 123 E NORTH AVE
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City | FLORA
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State | IL
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Zip | 62839-2028
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Country | US
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Telephone | 618-662-2174
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Fax | 618-662-9442
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Provider Business Mailing Address
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Address Line | PO BOX 577
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City | FLORA
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State | IL
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Zip | 62839-0577
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Country | US
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Telephone | 618-662-2174
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Fax | 618-662-9442
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Authorized Official
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Title or Position | OWNER
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Name | BOB POWLESS
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Credential |
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Telephone | 618-662-2174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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