Organization
AXLINE'S INC.
Active
Other names
Axline Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TROY WILLIAMS RPH (OWNER/PRESIDENT)
(309) 660-5939
Entity
Organization
Contact information
Practice address
324 S. MCCOY STREET, GRANVILLE, IL 61326
(815) 339-2323
(815) 339-2324
Mailing address
PO BOX 1087, BLOOMINGTON, IL 61702-1087
(309) 828-6979
(309) 828-6978
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1488495
NCPDP
IL
Enumeration date
11/20/2013
Last updated
03/16/2022
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