Organization
D DIKO LLC
Active
Other names
Fawcett's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEENA D. CHIRKINA PHARMD (OWNER/PHARMD/PIC)
(815) 872-3251
Entity
Organization
Contact information
Practice address
519 S MAIN ST, PRINCETON, IL 61356-2006
(815) 872-3251
(815) 872-1594
Mailing address
519 S MAIN ST, PRINCETON, IL 61356-2006
(815) 872-3251
(815) 872-1594
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054019824
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160617
PK
—
Enumeration date
10/12/2005
Last updated
12/05/2024
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