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General NPI Number Information
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NPI Number | 1851483564
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Entity Type | Organization
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Legal Business Name | PEORIA COUNTY DRUGS, INC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 8600 N STATE ROUTE 91 SUITE 100
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City | PEORIA
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State | IL
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Zip | 61615-9541
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Country | US
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Telephone | 309-691-9800
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Fax | 309-691-3305
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Provider Business Mailing Address
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Address Line | 8600 N STATE ROUTE 91 SUITE 100
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City | PEORIA
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State | IL
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Zip | 61615-9541
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Country | US
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Telephone | 309-691-9800
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Fax | 309-691-3305
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. WAYNE R BEEKMAN
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Credential | RPH
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Telephone | 309-691-9800
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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 |
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License Number State | IL
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Taxonomy #2
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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 | IL
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