Organization
VERNON ANDERSEN INC
Active
Other names
MEDICINE SHOPPE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON EUGENE ANDERSEN RPH (PRESIDENT)
(618) 377-5356
Entity
Organization
Contact information
Practice address
341 W BETHALTO DR, BETHALTO, IL 62010-1779
(618) 377-5356
(618) 377-0159
Mailing address
341 W BETHALTO DR, BETHALTO, IL 62010-1779
(618) 377-5356
(618) 377-0159
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
054014647
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467631
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
364151335001
—
IL
Enumeration date
08/10/2006
Last updated
03/07/2023
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