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Organization

ALTON MEMORIAL HOSPITAL

Active
Other names
Home Care Pharmacy LTC
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY MUELLER (PHARMACY MANAGER)
(618) 463-7425
Entity
Organization

Contact information

Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7610
(618) 463-7722
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7610
(618) 463-7722

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
054017172
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1466843
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
07/25/2006
Last updated
10/01/2012
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