Organization
MAIN STREET PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE MILES (PRESIDENT)
(309) 547-3731
Entity
Organization
Contact information
Practice address
195 S MAIN ST, LEWISTOWN, IL 61542-1412
(309) 547-3731
(309) 547-2040
Mailing address
195 S MAIN ST, LEWISTOWN, IL 61542-1412
(309) 547-3731
(309) 547-2040
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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