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General NPI Number Information
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NPI Number | 1740264340
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Entity Type | Organization
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Legal Business Name | DOT DRUG INC.
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 505 JUBILEE LN
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City | METAMORA
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State | IL
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Zip | 61548-8472
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Country | US
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Telephone | 309-383-3000
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Fax | 309-383-3048
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Provider Business Mailing Address
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Address Line | 505 JUBILEE LN
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City | METAMORA
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State | IL
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Zip | 61548-8472
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Country | US
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Telephone | 309-383-3000
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Fax | 309-383-3048
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARLIN WEEKLEY
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Credential |
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Telephone | 309-383-3000
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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 | 054014334
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License Number State | IL
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