MEDICARE: CLAUSEN PHARMACY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy		IL

General Provider Information

NPI Number	:	1326077546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAUSEN PHARMACY

Provider Business Mailing Address
First Line	:	59 CEDAR SQ
Second Line	:
City	:	CLINTON
State	:	IL
Zip	:	61727-2201
Country	:	US
Telephone Number	:	217-935-5856
Fax Number	:	217-935-6700

Provider Business Practice Location Address
First Line	:	59 CEDAR SQ
Second Line	:
City	:	CLINTON
State	:	IL
Zip	:	61727-2201
Country	:	US
Telephone Number	:	217-935-5856
Fax Number	:	217-935-6700

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	MR. CARL CHRIS CLAUSEN
Credential	:	R.PH.
Telephone Number	:	217-935-5856

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	08/22/2020

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