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Organization
PHARMAX INC.
Active
Organization
PHARMAX INC.
Active
Other names
dba Pharmax Pharmacy #0912
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY T MCINTOSH (PRESIDENT)
(314) 954-5510
Entity
Organization
Contact information
Practice address
1221 CHARLESTON AVE, MATTOON, IL 61938-4130
(217) 234-8881
(217) 234-8885
Mailing address
1221 CHARLESTON AVE, MATTOON, IL 61938-4130
(217) 234-8881
(217) 234-8885
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
051030067
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1455927
NCPDP #
IL
Enumeration date
08/31/2006
Last updated
03/07/2023
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