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Organization

BYRD-WATSON TIMES SQUARE DRUG CO

Active
Other names
Byrd-Watson Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
ADAM BREEZE (OFFICER OF THE CORPORATION)
(618) 244-5400
Entity
Organization

Contact information

Practice address
3401 BROADWAY ST, MOUNT VERNON, IL 62864-2201
(618) 244-5400
(618) 244-5988
Mailing address
PO BOX 1179, MOUNT VERNON, IL 62864-0024
(618) 244-5400
(618) 244-5409

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054009959
IL
3336C0003X
Community/Retail Pharmacy
Primary
054.009959
IL

Other

Enumeration date
08/09/2006
Last updated
04/08/2025
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