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Organization

GARDNER PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CURT PAUL TRIZZINO MSHSA (OWNER)
(815) 237-2152
Entity
Organization

Contact information

Practice address
122 DEPOT, GARDNER, IL 60424
(815) 237-2152
(815) 237-0858
Mailing address
122 DEPOT ST, GARDNER, IL 60424
(815) 237-2152
(815) 237-0858

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
IL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
363771367001
IL
Enumeration date
10/06/2006
Last updated
11/28/2007
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