Organization
BODE DRUG INC
Active
Other names
BODE DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
CARL BODE (PRESIDENT)
(618) 748-9253
Entity
Organization
Contact information
Practice address
225 E MAIN ST, GOLCONDA, IL 62938
(618) 683-3311
(618) 683-4445
Mailing address
PO BOX 364, 225 E MAIN ST, GOLCONDA, IL 62938-0364
(618) 683-3311
(618) 683-4445
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018125
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139132
PK
—
Enumeration date
11/24/2006
Last updated
01/17/2017
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