Organization
PEKIN PROHEALTH INC
Active
Other names
Park Court Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOB HALEY (PRESIDENT)
(309) 347-1151
Entity
Organization
Contact information
Practice address
600 S 13TH ST, PEKIN, IL 61554-4936
(309) 347-9455
(309) 347-1886
Mailing address
600 S 13TH ST, PEKIN, IL 61554-4936
(309) 347-9455
(309) 347-1886
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054009001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1453810
NCPDP
IL
Enumeration date
08/24/2006
Last updated
04/03/2017
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