Organization
SANDERS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH WAYNE SANDERS R.PH. (OWNER/PHARMACIST)
(217) 427-2156
Entity
Organization
Contact information
Practice address
112 E. VERMILION STREET, CATLIN, IL 61817-0648
(217) 427-2156
(217) 427-5701
Mailing address
PO BOX 648, CATLIN, IL 61817-0648
(217) 427-2156
(217) 427-5701
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1446942
NCPDP
IL
Enumeration date
05/12/2006
Last updated
08/22/2020
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