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General NPI Number Information
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NPI Number | 1568557593
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Entity Type | Organization
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Legal Business Name | PHARMACY PLUS INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 508 N MAIN ST
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City | CARROLLTON
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State | IL
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Zip | 62016-1027
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Country | US
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Telephone | 217-942-3427
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Fax | 217-942-3130
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Provider Business Mailing Address
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Address Line | 508 N MAIN ST
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City | CARROLLTON
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State | IL
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Zip | 62016-1027
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Country | US
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Telephone | 217-942-3427
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Fax | 217-942-3130
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Authorized Official
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Title or Position | PRESIDENT
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Name | BYRON BERRY
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Credential |
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Telephone | 217-942-3427
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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 | 054014799
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License Number State | IL
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