Organization
THE MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ED POTTS PHD (OWNER/PHARMACIST)
(618) 842-6007
Entity
Organization
Contact information
Practice address
1116 W MAIN ST, FAIRFIELD, IL 62837-2324
(618) 842-6007
(618) 842-4816
Mailing address
1116 W MAIN ST, FAIRFIELD, IL 62837-2324
(618) 842-6007
(618) 842-4816
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000745
IL
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
About Stedi
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