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Organization
ALTON MEMORIAL HOSPITAL
Active
Organization
ALTON MEMORIAL HOSPITAL
Active
Other names
Home Care Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MUELLER (PHARMACY MANAGER)
(618) 463-7425
Entity
Organization
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7610
(618) 463-7722
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7610
(618) 463-7722
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
054017172
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1466843
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/25/2006
Last updated
10/01/2012
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