Organization
LINCOLNSHIRE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE GENE WILKS R.PH. (OWNER)
(618) 244-3044
Entity
Organization
Contact information
Practice address
4230 LINCOLNSHIRE DR, SUITE F, MOUNT VERNON, IL 62864-2189
(618) 244-3044
(618) 244-3067
Mailing address
4230 LINCOLNSHIRE DR, SUITE F, MOUNT VERNON, IL 62864-2189
(618) 244-3044
(618) 244-3067
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054008911
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1452729
NCPDP
IL
Enumeration date
02/14/2007
Last updated
06/25/2008
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