Organization
PRN PHARMACIES LTD
Active
Other names
MEDICAP PHARMACY, Medicine Shoppe #2171
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD LEDBETTER (VICE PRESIDENT)
(618) 252-5349
Entity
Organization
Contact information
Practice address
1101 US HIGHWAY 45 N, ELDORADO, IL 62930-3768
(618) 273-4941
(618) 273-8124
Mailing address
1101 US HIGHWAY 45 N, PO BOX 449, ELDORADO, IL 62930-3768
(618) 273-4941
(618) 273-8124
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
54006692
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1440217
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
371061340001
—
IL
01
—
3710613406293001
HFS PAYEE #
IL
Enumeration date
02/27/2007
Last updated
12/29/2025
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