Organization
SHARSHON PHARMACY INC
Active
Other names
Wenona Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER SHARSHON RPH (PRESIDENT)
(630) 210-5307
Entity
Organization
Contact information
Practice address
120 N CHESTNUT ST, WENONA, IL 61377-7527
(815) 853-4342
(815) 853-4348
Mailing address
120 CHESTNUT ST., WENONA, IL 61377-0602
(815) 853-4342
(815) 853-4348
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054006145
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054020970
PHARMACY
IL
05
—
362889967001
—
IL
Enumeration date
08/21/2006
Last updated
12/07/2018
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