# SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shawnee Health Pharmacy Carbondale
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760253447
- **Authorized official:** CHRISTINA CARNEY (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (618) 956-9521

## Contact information

- **Practice address:** 400 S LEWIS LN STE 200, CARBONDALE, IL 62901-3547
- **Practice address phone:** (618) 519-9200
- **Mailing address:** 400 S LEWIS LN STE 200, CARBONDALE, IL 62901-3547
- **Mailing address phone:** (618) 519-9200

## Taxonomy

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

## Other

- **Enumeration date:** 01/11/2024
- **Last updated:** 07/26/2024