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Organization
PBCC PHARMACY LLC
Active
Organization
PBCC PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVALDO WESLY (MEDICAL DIRECTOR)
(217) 414-1041
Entity
Organization
Contact information
Practice address
1500 W WASHINGTON ST STE B, SPRINGFIELD, IL 62702-4756
(217) 546-7100
Mailing address
105 S AMOS AVE, SPRINGFIELD, IL 62704-1528
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
04/01/2020
Last updated
04/07/2025
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