Organization
GROCERIES OF SOUTHERN ILLINOIS LLC
Active
Other names
new athens pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN SCHNEIDER PHARMD (DIRECTOR OF PHARMACY)
(618) 539-5577
Entity
Organization
Contact information
Practice address
901 SPOTSYLVANIA ST, NEW ATHENS, IL 62264-1569
(618) 566-6843
(618) 475-9219
Mailing address
10 SOUTHGATE CTR, FREEBURG, IL 62243-1541
(618) 539-5577
(618) 539-3089
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018344
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143033
PK
—
05
—
371239582001
—
IL
Enumeration date
11/27/2013
Last updated
10/15/2021
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