Organization
MERCER CTY HOSPITAL
Active
Other names
MERCER COUNTY HOSPITAL OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIM PUTNAM (CEO)
(309) 582-5301
Entity
Organization
Contact information
Practice address
409 N.W. 9TH AVE, OUTPATIENT PHARMACY, ALEDO, IL 61231
(309) 582-3710
(309) 582-3737
Mailing address
409 N.W. 9TH AVE, OUTPATIENT PHARMACY, ALEDO, IL 61231
(309) 582-3710
(309) 582-3737
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
093013445
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1452755
NCPDP
IL
Enumeration date
10/03/2006
Last updated
07/08/2008
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