Organization
ALTON MEMORIAL HOSPITAL
Active
Other names
FAMILY CARE PHARMACY AT ALTON MEMORIAL HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BRAASCH (PRESIDENT)
(618) 463-7301
Entity
Organization
Contact information
Practice address
1 MEMORIAL DR, ROOM G247, ALTON, IL 62002-6722
(618) 463-7865
(618) 463-7884
Mailing address
1 MEMORIAL DR, ROOM G247, ALTON, IL 62002-6722
(618) 463-7865
(618) 463-7884
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054011644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022352
PK
—
Enumeration date
08/22/2006
Last updated
03/22/2021
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