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Organization
PECATONICA PHARMACY INC
Active
Organization
PECATONICA PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA M WIEGERT RPH (PRESIDENT)
(815) 239-1200
Entity
Organization
Contact information
Practice address
413 MAIN STREET, PECATONICA, IL 61063-0550
(815) 239-1200
(815) 239-1011
Mailing address
PO BOX 550, PECATONICA, IL 61063-0550
(815) 239-1200
(815) 239-1011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363129225001
—
IL
Enumeration date
08/24/2006
Last updated
08/22/2020
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