Organization
ABADA HEALTH SOURCE LLC
Active
Other names
MEDPLUS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
FIDELIS OKEKE (PHARMACIST IN CHARGE)
(217) 442-1100
Entity
Organization
Contact information
Practice address
511 W FAIRCHILD ST UNIT B, DANVILLE, IL 61832-3801
(217) 431-6662
(217) 442-1101
Mailing address
511 W FAIRCHILD ST UNIT B, DANVILLE, IL 61832-3801
(217) 431-6662
(217) 442-1101
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054018934
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149868
PK
—
Enumeration date
02/10/2015
Last updated
02/10/2015
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