# ALTAMONT PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ALTAMONT PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164472304
- **Authorized official:** DOUG PHILLIPS (PRESIDENT)
- **Authorized official phone:** (618) 483-5614

## Contact information

- **Practice address:** 12 N 3RD ST, ALTAMONT, IL 62411-1408
- **Practice address phone:** (618) 483-5614
- **Practice address fax:** (618) 483-3425
- **Mailing address:** 12 N 3RD ST, ALTAMONT, IL 62411-1408
- **Mailing address phone:** (618) 483-5614
- **Mailing address fax:** (618) 483-3425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054008775 | IL | Yes |
| 3336L0003X | Long Term Care Pharmacy | 054008775 | IL | — |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 08/08/2016