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General NPI Number Information
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NPI Number | 1679844534
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Entity Type | Organization
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Legal Business Name | EKMKK PHARMACY LLC
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 37 W MAIN ST
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City | ALBION
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State | IL
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Zip | 62806-1006
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Country | US
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Telephone | 618-445-2581
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Fax | 618-445-3161
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Provider Business Mailing Address
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Address Line | 37 W MAIN ST
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City | ALBION
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State | IL
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Zip | 62806-1006
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Country | US
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Telephone | 618-445-2581
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Fax | 618-445-3161
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Authorized Official
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Title or Position | OWNER/PIC
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Name | ERIC RIGG
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Credential |
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Telephone | 618-445-2581
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054017845
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License Number State | IL
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