Organization
MBRX INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN R BARRON RPH (PRES MBRX PHARMACIST)
(217) 245-1077
Entity
Organization
Contact information
Practice address
1111 W MORTON AVE, JACKSONVILLE, IL 62650-3165
(217) 245-1077
(217) 245-0006
Mailing address
1111 W MORTON AVE, JACKSONVILLE, IL 62650-3165
(217) 245-1077
(217) 245-0006
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
054014047
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1456765
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3116317906265001
—
IL
05
—
371239851001
—
IL
Enumeration date
08/31/2006
Last updated
03/07/2023
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