Organization
POTTER PHARMACY INC
Active
Other names
POTTER DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK POTTER (PRESIDENT)
(217) 632-2288
Entity
Organization
Contact information
Practice address
200 S 6TH ST, PETERSBURG, IL 62675-1553
(217) 632-2287
(217) 632-2033
Mailing address
PO BOX 498, PETERSBURG, IL 62675-0498
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054006072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023312
PK
—
Enumeration date
11/09/2005
Last updated
03/06/2014
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