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Organization
CAMARATO DRUG INC
Active
Organization
CAMARATO DRUG INC
Active
Other names
LOGAN PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATT CAMARATO PHARMACIST (PRESIDENT)
(618) 993-5555
Entity
Organization
Contact information
Practice address
303 RUSHING DR, HERRIN, IL 62948-3749
(618) 993-5555
(618) 993-6800
Mailing address
PO BOX 398, HERRIN, IL 62948-0398
(618) 993-5555
(618) 993-6800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
54014826
IL
3336C0004X
Compounding Pharmacy
—
NULL
3336M0003X
Managed Care Organization Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021253
PK
—
Enumeration date
08/10/2006
Last updated
12/04/2015
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