Organization
CHR-ASH INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BURDGE RPH (OWNER PHARMACIST)
(618) 451-4200
Entity
Organization
Contact information
Practice address
1529 JOHNSON RD, GRANITE CITY, IL 62040-3831
(618) 451-4200
(618) 451-4252
Mailing address
1529 JOHNSON RD, GRANITE CITY, IL 62040-3831
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054008703
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1451563
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
03/07/2023
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