Organization
DKM PHARMACY INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TOM MILLER RPH (OWNER PHARMACIST)
(618) 997-2030
Entity
Organization
Contact information
Practice address
1200 W MAIN ST, MARION, IL 62959-1138
(618) 997-2030
(618) 993-3565
Mailing address
1200 W MAIN ST, MARION, IL 62959-1138
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
54014619
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1474256
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
03/07/2023
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