Organization
HOLISTIC PHARMACY SERVICES INC
Active
Other names
The Medicine Shoppe Pharmacy, Holistic Pharmacy and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEAUX COLE PHARMD (PRESIDENT)
(217) 679-9244
Entity
Organization
Contact information
Practice address
133 E NORTH GRAND AVE, SPRINGFIELD, IL 62702-3859
(217) 679-9244
(217) 525-0034
Mailing address
133 E NORTH GRAND AVE, SPRINGFIELD, IL 62702-3859
(217) 525-0058
(217) 525-0034
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
054017739
IL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132238
PK
—
Enumeration date
06/30/2011
Last updated
07/10/2019
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