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Organization

AXLINE'S INC.

Active
Other names
Axline Pharmacy (08)
Organization subpart
No

Provider details

NPI number
Authorized official
TROY WILLIAMS (OWNER,RPH,AO)
(309) 828-6767
Entity
Organization

Contact information

Practice address
401 W MAIN ST, BUSHNELL, IL 61422-1353
(309) 772-3155
(309) 772-3156
Mailing address
PO BOX 1087, BLOOMINGTON, IL 61702-1087
(309) 828-6767
(309) 828-6970

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018760
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1413385
NCPDP
IL
Enumeration date
01/22/2007
Last updated
03/16/2022
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