Organization
CHRISTIE PHARMACY CHAMPAIGN LLC
Active
Other names
Christie Pharmacy Champaign LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE DUMMLER (PHARMACY MANAGER)
(217) 366-1278
Entity
Organization
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1278
(217) 366-6897
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1278
(217) 366-6897
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016506
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1413878
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
370802668003
—
IL
Enumeration date
10/04/2006
Last updated
04/29/2010
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