Organization
ILLINI CLINIC PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY R MERIDETH RPH (PRESIDENT)
(309) 792-7002
Entity
Organization
Contact information
Practice address
855 ILLINI DR, SUITE 200, SILVIS, IL 61282-2907
(309) 792-7002
(309) 792-7003
Mailing address
855 ILLINI DR, SUITE 200, SILVIS, IL 61282-2907
(309) 792-7002
(309) 792-7003
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054013807
IL
3336L0003X
Long Term Care Pharmacy
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Other
Enumeration date
04/26/2007
Last updated
07/01/2020
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