Organization
LADD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD GIACOMELLI RPH (PHARMACIST)
(815) 894-2207
Entity
Organization
Contact information
Practice address
202 N MAIN, LADD, IL 61329
(815) 894-2207
(815) 894-2343
Mailing address
PO BOX 555, LADD, IL 61329-0555
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054009722
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1410365
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
07/10/2008
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