Organization
G M ANDES LTD
Active
Other names
ANDES HEALTH MART
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT ANDES (OWNER)
(217) 342-9393
Entity
Organization
Contact information
Practice address
805 W FAYETTE AVE, EFFINGHAM, IL 62401-2415
(217) 342-9393
(217) 342-9409
Mailing address
805 W FAYETTE AVE, EFFINGHAM, IL 62401-2415
(217) 342-9393
(217) 342-9409
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054014035
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019673
PK
—
05
—
371236737001
—
IL
Enumeration date
05/11/2006
Last updated
01/31/2022
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