Sulivan Drugs Of Gillespie

LBN: Ageless Rx Systems Llc
Sulivan Drugs Of Gillespie is an health care organization with primary practice located at 103 N Jersey St Suite 101, Gillespie IL 62033. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Ageless Rx Systems Llc can be contacted via phone (217) 839-2877, or through Allan, Terry via phone (217) 839-2877.

Contact Information

Primary practice address
103 N Jersey St Suite 101 Gillespie IL 62033
Phone: (217) 839-2877
Fax: (217) 839-3233
Website:
Map and Directions
Authorized official contact:
Name: Allan, Terry PHARM D.
Phone: (217) 839-2877

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 054002139 Illinois

Profile Details

NPI number 1134104219
LBN Legal business name Ageless Rx Systems Llc
DBA Doing business as Sulivan Drugs Of Gillespie
Authorized official Allan, Terry PHARM D.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2005
Last updated Aug 22nd, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134104219 NPPES
Other 2023083 PK
MEDICAID 370647772001 PK

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