Organization
SHARSHON PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER SHARSHON (OWNER)
(630) 210-5307
Entity
Organization
Contact information
Practice address
101 W MARKET ST, MOUNT CARROLL, IL 61053
(815) 244-2171
(815) 244-1174
Mailing address
931 W GALENA BLVD, AURORA, IL 60506-3751
(815) 244-2171
(815) 244-1174
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018564
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144340
PK
—
Enumeration date
01/30/2014
Last updated
08/24/2018
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