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Organization
HERRIN DRUG INC
Active
Organization
HERRIN DRUG INC
Active
Other names
Herrin Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALLEN MATTINGLY R.PH. (PRESIDENT/PHARMACIST)
(618) 942-5315
Entity
Organization
Contact information
Practice address
116 N PARK AVE, HERRIN, IL 62948-3148
(618) 942-5315
(618) 942-4584
Mailing address
116 N PARK AVE, HERRIN, IL 62948-3148
(618) 942-5315
(618) 942-4584
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
054007687
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
10/26/2005
Last updated
11/24/2020
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