Organization
GODFREY PRESCRIPTION SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERRY EUGENE LECLAIRE R.PH. (OWNER)
(618) 466-5577
Entity
Organization
Contact information
Practice address
5701 GODFREY RD, GODFREY, IL 62035-2471
(618) 466-5577
(618) 466-5577
Mailing address
5701 GODFREY RD, GODFREY, IL 62035-2471
(618) 466-5577
(618) 466-5577
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Enumeration date
08/14/2006
Last updated
01/23/2008
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