# ARKINS DRUG STORE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619027901
- **Authorized official:** DEAN WILMOR RPH (RPH)
- **Authorized official phone:** (815) 223-0460

## Contact information

- **Practice address:** 1033 8TH ST, LA SALLE, IL 61301-1935
- **Practice address phone:** (815) 223-0460
- **Practice address fax:** (815) 223-0462
- **Mailing address:** 1033 8TH ST, LA SALLE, IL 61301-1935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054013897 | IL | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 11/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1423932 | OTHER ID NUMBER | — |
| 05 | — | 3664097450001 | — | IL |