Organization
PEKIN PRESCRIPTION LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK L. PROBASCO R.PH. (PRESIDENT)
(309) 346-2141
Entity
Organization
Contact information
Practice address
1016 COURT ST, PEKIN, IL 61554-4818
(309) 346-2141
(309) 346-7903
Mailing address
1016 COURT ST, PEKIN, IL 61554-4818
(309) 346-2141
(309) 346-7903
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203-0007711
IL
3336C0003X
Community/Retail Pharmacy
054.017927
IL
Other
Enumeration date
05/09/2006
Last updated
03/30/2015
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