# AXLINE'S INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Axline Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407286941
- **Authorized official:** TROY WILLIAMS RPH (OWNER/PRESIDENT)
- **Authorized official phone:** (309) 660-5939

## Contact information

- **Practice address:** 324 S. MCCOY STREET, GRANVILLE, IL 61326
- **Practice address phone:** (815) 339-2323
- **Practice address fax:** (815) 339-2324
- **Mailing address:** PO BOX 1087, BLOOMINGTON, IL 61702-1087
- **Mailing address phone:** (309) 828-6979
- **Mailing address fax:** (309) 828-6978

## Taxonomy

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

## Other

- **Enumeration date:** 11/20/2013
- **Last updated:** 03/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1488495 | NCPDP | IL |