Organization
HOME CARE PHARMACY REFILL CTR
Active
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) 463-7833
(618) 463-7722
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475385
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/25/2006
Last updated
08/22/2020
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