Individual
ELAINE MARY GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 N STATE RD, FLORA, IL 62839-1093
(618) 662-4767
(618) 662-2657
Mailing address
PO BOX 714, OLNEY, IL 62450-0714
(618) 838-7835
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051034921
IL
Other
Enumeration date
11/22/2020
Last updated
11/22/2020
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