MEDICARE: GLEASON PHARMACY SERVICES INC

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

General Provider Information

NPI Number	:	1962260117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLEASON PHARMACY SERVICES INC

Provider Business Mailing Address
First Line	:	601 ROCK RIVER RD
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-8338
Country	:	US
Telephone Number	:	217-891-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3251 GINGER CREEK DR STE A
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-7423
Country	:	US
Telephone Number	:	217-891-1449
Fax Number	:	866-591-1654

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TIMOTHY ARTHUR GLEASON
Credential	:
Telephone Number	:	217-632-2288

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	06/20/2024

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