Organization
POLYCLINIC PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. INDERJIT S RAKALLA R.PH. (PRESIDENT)
(217) 446-3784
Entity
Organization
Contact information
Practice address
707 N LOGAN AVE, DANVILLE, IL 61832-4360
(217) 446-3784
(217) 446-0370
Mailing address
707 N LOGAN AVE, DANVILLE, IL 61832-4360
(217) 446-3784
(217) 446-0370
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
333600000X
Pharmacy
Primary
054009124
IL
Other
Enumeration date
01/19/2006
Last updated
08/10/2012
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