# MERCER CTY HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MERCER COUNTY HOSPITAL OUTPATIENT PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912091745
- **Authorized official:** TIM PUTNAM (CEO)
- **Authorized official phone:** (309) 582-5301

## Contact information

- **Practice address:** 409 N.W. 9TH AVE, OUTPATIENT PHARMACY, ALEDO, IL 61231
- **Practice address phone:** (309) 582-3710
- **Practice address fax:** (309) 582-3737
- **Mailing address:** 409 N.W. 9TH AVE, OUTPATIENT PHARMACY, ALEDO, IL 61231
- **Mailing address phone:** (309) 582-3710
- **Mailing address fax:** (309) 582-3737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 093013445 | IL | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 07/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1452755 | NCPDP | IL |