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General NPI Number Information
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NPI Number | 1437648342
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Entity Type | Organization
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Legal Business Name | WOODWARD CJS PHARMACY INC
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 901 E EDWARDSVILLE RD
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City | WOOD RIVER
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State | IL
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Zip | 62095-1823
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Country | US
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Telephone | 618-259-0085
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Fax | 618-259-0089
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Provider Business Mailing Address
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Address Line | 901 E EDWARDSVILLE RD
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City | WOOD RIVER
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State | IL
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Zip | 62095-1823
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Country | US
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Telephone | 618-259-0085
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Fax | 618-259-0089
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Authorized Official
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Title or Position | OWNER/PIC
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Name | JILL WOODWARD
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Credential |
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Telephone | 618-259-0085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 054015916
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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