# BODE DRUG INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BODE DRUG INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417022310
- **Authorized official:** CARL BODE (PRESIDENT)
- **Authorized official phone:** (618) 748-9253

## Contact information

- **Practice address:** 225 E MAIN ST, GOLCONDA, IL 62938
- **Practice address phone:** (618) 683-3311
- **Practice address fax:** (618) 683-4445
- **Mailing address:** PO BOX 364, 225 E MAIN ST, GOLCONDA, IL 62938-0364
- **Mailing address phone:** (618) 683-3311
- **Mailing address fax:** (618) 683-4445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054018125 | IL | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 01/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2139132 | PK | — |