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General NPI Number Information
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NPI Number | 1851763924
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Entity Type | Organization
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Legal Business Name | BOBROWSKI INDUSTRIES PRINCETON LLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 519 S MAIN ST
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City | PRINCETON
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State | IL
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Zip | 61356-2006
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Country | US
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Telephone | 815-872-3251
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1000
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City | BOONEVILLE
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State | KY
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Zip | 41314-1000
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Country | US
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Telephone | 606-599-5515
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NELSON BOBROWSKI
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Credential |
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Telephone | 606-599-5515
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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 | 054014751
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License Number State | IL
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