Organization
SULLIVAN DRUGS OF LITCHFIELD INC
Active
Other names
SULLIVAN DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE SULLIVAN (V.P./TRES)
(217) 839-2909
Entity
Organization
Contact information
Practice address
320 E UNION AVE, LITCHFIELD, IL 62056-1575
(217) 324-2001
(217) 324-6001
Mailing address
320 E UNION AVE, LITCHFIELD, IL 62056-1575
(217) 324-2001
(217) 324-6001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.017871
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133524
PK
—
Enumeration date
01/20/2012
Last updated
12/22/2016
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