Organization
ANTONACCI INC
Active
Other names
MEDICINE STOP OF PEORIA
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ANTONACCI RPH (PHARMACIST AND PRESIDENT)
(309) 685-5939
Entity
Organization
Contact information
Practice address
4410 N KNOXVILLE AVE, STE A, PEORIA, IL 61614-6086
(309) 685-5939
(309) 685-5930
Mailing address
4410 N KNOXVILLE AVE, STE A, PEORIA, IL 61614-6086
(309) 685-5939
(309) 685-5930
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054009135
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1454545
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2007
Last updated
04/12/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us