# PLUM STREET PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Plum Street Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619245404
- **Authorized official:** DON GEE (PHARMACIST/OWNER)
- **Authorized official phone:** (618) 382-8330

## Contact information

- **Practice address:** 311 PLUM ST, CARMI, IL 62821-1632
- **Practice address phone:** (618) 382-8400
- **Practice address fax:** (618) 382-5700
- **Mailing address:** 311 PLUM ST, CARMI, IL 62821-1632
- **Mailing address phone:** (618) 382-8400
- **Mailing address fax:** (618) 382-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054.017833 | IL | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/07/2011
- **Last updated:** 03/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2132742 | PK | — |
| 05 | — | 349683015001 | — | IL |