MEDICARE: PHARMACY PLUS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033179668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY PLUS, INC.

Provider Business Mailing Address
First Line	:	502 CHESTNUT ST
Second Line	:
City	:	GREENFIELD
State	:	IL
Zip	:	62044-1305
Country	:	US
Telephone Number	:	217-368-2667
Fax Number	:	217-368-3140

Provider Business Practice Location Address
First Line	:	502 CHESTNUT ST
Second Line	:
City	:	GREENFIELD
State	:	IL
Zip	:	62044-1305
Country	:	US
Telephone Number	:	217-368-2667
Fax Number	:	217-368-3140

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BYRON A BERRY JR.
Credential	:	R.PH.
Telephone Number	:	217-248-6868

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	05/29/2019

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Directions to “PHARMACY PLUS, INC. ” Practice Location

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