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Organization
SENIOR MED SERVICES INC
Active
Organization
SENIOR MED SERVICES INC
Active
Other names
UVANTA Pharmacy - Southern Illinois
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STOECKLIN RPH (PRESIDENT)
(618) 993-2900
Entity
Organization
Contact information
Practice address
7846 AVIATION DR, MARION, IL 62959-5818
(618) 993-2900
(618) 998-1485
Mailing address
7846 AVIATION DR, MARION, IL 62959-5818
(618) 993-2900
(618) 998-1485
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
58013523
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021772
PK
—
05
—
7100202430
—
KY
01
—
F300256063
MEDICARE B MASS IMMUNIZATION ROSTER
IL
Enumeration date
01/03/2007
Last updated
03/04/2016
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