Organization
AXLINE'S INC.
Active
Other names
Flanagan Health Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TROY WILLIAMS (OWNER/RPH)
(309) 828-6767
Entity
Organization
Contact information
Practice address
116 S MAIN ST, FLANAGAN, IL 61740-7536
(815) 796-2274
(815) 796-3277
Mailing address
PO BOX 1087, BLOOMINGTON, IL 61702-1087
(309) 828-6767
(309) 828-6978
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-018165
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1453668
NCPDP
IL
Enumeration date
05/11/2006
Last updated
03/16/2022
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