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Organization
AGELESS RX SYSTEMS LLC
Active
Organization
AGELESS RX SYSTEMS LLC
Active
Other names
Sulivan Drugs of Gillespie
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY ALLAN PHARM D. (OWNER)
(217) 839-2877
Entity
Organization
Contact information
Practice address
103 N JERSEY ST, SUITE 101, GILLESPIE, IL 62033
(217) 839-2877
(217) 839-3233
Mailing address
103 N JERSEY ST, SUITE 101, GILLESPIE, IL 62033
(217) 839-2877
(217) 839-3233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054002139
IL
Other
Enumeration date
12/12/2005
Last updated
02/09/2025
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