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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