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Organization

PORTER DRUG INC

Active
Other names
Porters Village RX
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD J PORTER RPH (OWNER RPH)
(309) 755-3862
Entity
Organization

Contact information

Practice address
621 STATE AVENUE, HAMPTON, IL 61256
(309) 755-3862
(309) 755-4126
Mailing address
PO BOX 307, 621 STATE AVENUE, HAMPTON, IL 61256
(309) 755-3862
(309) 755-4126

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1423184
NABP
IL
Enumeration date
12/26/2006
Last updated
08/22/2020
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