EXTENDED PHARMACY LLC
Organization (NPI-2)
Active
Pharmacy, Long Term Care Pharmacy
Provider Information
- NPI Number
1700014446- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 121 STATE ST STE 1A, PEORIA, IL, 616021547
- Phone
- (309) 676-4831
- Fax
- (309) 676-7014
Specialties & Taxonomies
Pharmacy
License: IN #64002202a
Pharmacy, Long Term Care Pharmacy
License: MO #2015044792
Pharmacy, Long Term Care Pharmacy
Primary License: IL #054016704