Organization
BRENT FAMILY PHARMACY INC
Active
Other names
BRENT FAMILY HEALTHMART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE JOHNSON RPH (PHARMACIST IN CHARGE)
(309) 924-2300
Entity
Organization
Contact information
Practice address
101 S DIVISION ST # 150, STRONGHURST, IL 61480-5033
(309) 924-2300
(309) 924-2302
Mailing address
101 S DIVISION ST, BOX 150, STRONGHURST, IL 61480-5033
(309) 924-2300
(309) 924-2302
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.017495
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485069
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/15/2010
Last updated
04/09/2012
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