Organization
GREEN TREE PHARMACY, INC.
Active
Other names
Green Tree Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. GEORGE PHARMD (VICE PRESIDENT)
(309) 432-3451
Entity
Organization
Contact information
Practice address
1305 CAROLYN DR, MINONK, IL 61760
(309) 432-3451
(309) 432-2575
Mailing address
1305 N CAROLYN DR, MINONK, IL 61760-9326
(309) 432-3451
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
032-006965
IL
333600000X
Pharmacy
Primary
058-013453
IL
3336L0003X
Long Term Care Pharmacy
058-013453
IL
3336S0011X
Specialty Pharmacy
058-013453
IL
Other
Enumeration date
11/01/2005
Last updated
08/29/2024
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