Organization
CAINS DRUG STORE INC
Active
Other names
CAINS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL TJADEN (PRESIDENT AND PHARMACIST)
(618) 283-0196
Entity
Organization
Contact information
Practice address
1401 N 8TH ST, VANDALIA, IL 62471-1028
(618) 283-0196
(618) 283-9150
Mailing address
1401 N 8TH ST, VANDALIA, IL 62471-1028
(618) 283-0196
(618) 283-9150
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.008683
IL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016689
PK
—
Enumeration date
07/27/2006
Last updated
04/04/2016
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