# GENEVA PHARMACY LLC

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

## Provider details

- **NPI number:** 1639848021
- **Authorized official:** DR. CLARKE KUELTZO PHARMD (PRESIDENT)
- **Authorized official phone:** (331) 265-6136

## Contact information

- **Practice address:** 501 E STATE ST, GENEVA, IL 60134-2338
- **Practice address phone:** (331) 265-6136
- **Practice address fax:** (331) 265-6137
- **Mailing address:** 501 E STATE ST, GENEVA, IL 60134-2338
- **Mailing address phone:** (331) 265-6136
- **Mailing address fax:** (331) 265-6137

## Taxonomy

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

## Other

- **Enumeration date:** 09/08/2021
- **Last updated:** 09/15/2021