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General NPI Number Information
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NPI Number | 1457358202
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Entity Type | Organization
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Legal Business Name | LOCAL HEALTH, INC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 108 E MAIN ST
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City | ELMWOOD
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State | IL
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Zip | 61529-7963
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Country | US
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Telephone | 309-742-2611
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Fax | 309-742-3261
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Provider Business Mailing Address
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Address Line | 108 E MAIN ST
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City | ELMWOOD
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State | IL
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Zip | 61529-7963
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Country | US
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Telephone | 309-742-2611
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Fax | 309-742-3261
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Authorized Official
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Title or Position | SUPERVISOR
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Name | SELMA DZELIL
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Credential | PHARM.D
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Telephone | 815-715-8502
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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 | 054019803
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License Number State | IL
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