Organization
ALTAMONT PHARMACY INC
Active
Other names
ALTAMONT PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG PHILLIPS (PRESIDENT)
(618) 483-5614
Entity
Organization
Contact information
Practice address
12 N 3RD ST, ALTAMONT, IL 62411-1408
(618) 483-5614
(618) 483-3425
Mailing address
12 N 3RD ST, ALTAMONT, IL 62411-1408
(618) 483-5614
(618) 483-3425
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054008775
IL
3336L0003X
Long Term Care Pharmacy
054008775
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018826
PK
—
Enumeration date
05/10/2006
Last updated
08/08/2016
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