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Organization

MORTON-WUEBBELS PHARMACY INC

Active
Other names
Medicine Shoppe
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL MORTON (LICENSEE)
(618) 533-5411
Entity
Organization

Contact information

Practice address
817 E MCCORD, CENTRALIA, IL 62801
(618) 533-5411
(618) 533-4153
Mailing address
817 E MCCORD, CENTRALIA, IL 62801

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
054015743
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1471161
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
08/10/2006
Last updated
03/07/2023
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