# VASQUEZ PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Medicine Shoppe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376197699
- **Authorized official:** AMANDA VASQUEZ (PRESIDENT)
- **Authorized official phone:** (618) 612-5052

## Contact information

- **Practice address:** 134 S MAIN ST, COLUMBIA, IL 62236-2306
- **Practice address phone:** (618) 281-5135
- **Mailing address:** 134 S MAIN ST, COLUMBIA, IL 62236-2306
- **Mailing address phone:** (618) 281-5135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/25/2019
- **Last updated:** 02/21/2020