Organization
CAMARATO DRUG INC
Active
Other names
GOREVILLE PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW CAMARATO RPH (PRESIDENT)
(618) 995-1555
Entity
Organization
Contact information
Practice address
901 S BROADWAY, GOREVILLE, IL 62939-2477
(618) 995-1555
(618) 995-1553
Mailing address
PO BOX 398, HERRIN, IL 62948-0398
(618) 993-5555
(618) 993-6800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016439
IL
3336C0004X
Compounding Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023696
PK
—
Enumeration date
07/03/2008
Last updated
06/16/2021
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