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Organization
GREEN TREE PHARMACY, INC.
Active
Organization
GREEN TREE PHARMACY, INC.
Active
Other names
Green Tree Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. GEORGE PHARMD (VICE PRESIDENT)
(309) 432-3451
Entity
Organization
Contact information
Practice address
1305 CAROLYN DR, MINONK, IL 61760
(309) 432-3451
(309) 432-2575
Mailing address
1305 N CAROLYN DR, MINONK, IL 61760-9326
(309) 432-3451
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
032-006965
IL
333600000X
Pharmacy
Primary
058-013453
IL
3336L0003X
Long Term Care Pharmacy
058-013453
IL
3336S0011X
Specialty Pharmacy
058-013453
IL
Other
Enumeration date
11/01/2005
Last updated
08/29/2024
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