Organization
GRUNDY COUNTY DRUG CO INC
Active
Other names
Morris Healthmart Morris Family Discout Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CHARLES FUNK RPH. (PRESIDENT)
(815) 942-3662
Entity
Organization
Contact information
Practice address
2405 SYCAMORE DR, MORRIS, IL 60450-1020
(815) 942-3660
(815) 942-3641
Mailing address
2405 SYCAMORE DR, MORRIS, IL 60450-1020
(815) 942-3660
(815) 942-3641
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000611
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3221299
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/20/2006
Last updated
08/12/2011
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