# PHARMAX INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Pharmax Pharmacy \#9907
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073625679
- **Authorized official:** LARRY T MCINTOSH (PRESIDENT)
- **Authorized official phone:** (314) 954-5510

## Contact information

- **Practice address:** 925 N WESTERN AVE, WEST PEORIA, IL 61604-5129
- **Practice address phone:** (309) 676-4421
- **Mailing address:** 925 N WESTERN AVE, WEST PEORIA, IL 61604-5129
- **Mailing address phone:** (309) 676-4421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054014717 | IL | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1426217 | NCPDP \# | IL |