Organization
PAVILION FOUNDATION PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE SHEEHY (CEO)
(217) 373-1700
Entity
Organization
Contact information
Practice address
809 W CHURCH ST, CHAMPAIGN, IL 61820-3320
(217) 373-1860
(217) 373-1877
Mailing address
809 W CHURCH ST, CHAMPAIGN, IL 61820-3320
(217) 373-1860
(217) 373-1877
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
054016976
IL
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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