# GROCERIES OF SOUTHERN ILLINOIS, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Red Bud Country Mart Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912075151
- **Authorized official:** MRS. MEGHAN HEURING PHARM.D. (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (618) 539-3164

## Contact information

- **Practice address:** 1375 S MAIN ST, RED BUD, IL 62278-1352
- **Practice address phone:** (618) 282-6658
- **Practice address fax:** (618) 282-6488
- **Mailing address:** 1375 S MAIN ST, RED BUD, IL 62278-1352
- **Mailing address phone:** (618) 282-6658
- **Mailing address fax:** (618) 282-6488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054018566 | IL | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 08/04/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2023324 | PK | — |
| 05 | — | 371074357001 | — | IL |