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Organization
TMRDLR LLC
Active
Organization
TMRDLR LLC
Active
Other names
Okawville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNE RALLO (OWNER)
(618) 243-6228
Entity
Organization
Contact information
Practice address
403 N HANOVER ST, OKAWVILLE, IL 62271-1897
(618) 243-6228
(618) 243-5608
Mailing address
PO BOX 424, OKAWVILLE, IL 62271-0424
(618) 243-6228
(618) 243-5608
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.017658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485374
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/02/2011
Last updated
10/19/2012
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