Organization
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC
Active
Other names
QUNCY MEDICAL GROUP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY WOERMAN (CREDENTIALING SPECIALIST)
(217) 222-6550
Entity
Organization
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
004000187
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004000187
WHOLESALE DISTRIBU LICENS
IL
Enumeration date
02/15/2006
Last updated
12/20/2021
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