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General NPI Number Information
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NPI Number | 1649342742
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Entity Type | Organization
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Legal Business Name | KIMMEL-CHAPLAIN PHARMACY LTD
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 11/15/2020
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Provider Practice Location Address
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Address Line | 315 N MAIN ST
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City | BENTON
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State | IL
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Zip | 62812-1358
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Country | US
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Telephone | 618-438-2822
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Fax | 618-435-2885
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Provider Business Mailing Address
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Address Line | 315 N MAIN ST
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City | BENTON
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State | IL
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Zip | 62812-1358
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Country | US
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Telephone | 618-438-2822
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Fax | 618-435-2885
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Authorized Official
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Title or Position | RPH/OWNER
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Name | JULIE GIACONE
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Credential |
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Telephone | 618-438-2822
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054018920
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License Number State | IL
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