Organization
PRINCEVILLE PHARMACY LLC
Active
Other names
PRINCEVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FRYE (OWNER/PRESIDENT)
(309) 446-3292
Entity
Organization
Contact information
Practice address
206 E MAIN ST, PRINCEVILLE, IL 61559-7516
(309) 385-4955
(309) 385-1561
Mailing address
PO BOX 566, PRINCEVILLE, IL 61559-0566
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054014436
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1426471
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/20/2006
Last updated
02/22/2026
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