# APOTHECARY SHOPPE OF WEST SALEM INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE APOTHECARY SHOPPE W SALEM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093809402
- **Authorized official:** KIMBERLEY GRIFFITH RPH (PRES)
- **Authorized official phone:** (618) 456-3716

## Contact information

- **Practice address:** 108 S MAIN ST, WEST SALEM, IL 62476-1202
- **Practice address phone:** (618) 456-3716
- **Practice address fax:** (618) 456-2029
- **Mailing address:** PO BOX 68, WEST SALEM, IL 62476-0068
- **Mailing address phone:** (618) 456-3716
- **Mailing address fax:** (618) 456-2029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054008438 | IL | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 06/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2018508 | PK | — |