Organization
AXLINE'S INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY L WILLIAMS RPH (OWNER/RPH)
(309) 734-5196
Entity
Organization
Contact information
Practice address
125 N MAIN ST, ROSEVILLE, IL 61473-9574
(309) 426-2954
(309) 426-2565
Mailing address
220 N MAIN ST, MONMOUTH, IL 61462-1741
(309) 734-5196
(309) 734-5356
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
54009192
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1432195
NCPDP NUMBER
—
Enumeration date
08/14/2006
Last updated
03/10/2022
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