Organization
SPRINGFIELD CLINIC, LLP
Active
Other names
Springfield Clinic, LLP
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BREWER (DIRECTOR OF PHARMACY)
(217) 391-6940
Entity
Organization
Contact information
Practice address
900 N 1ST ST RM 4066, SPRINGFIELD, IL 62702-3749
(217) 391-6940
Mailing address
900 N 1ST ST RM 4066, SPRINGFIELD, IL 62702-3749
(217) 391-6940
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054.020218
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167219
PK
—
Enumeration date
01/17/2017
Last updated
01/17/2017
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