Sullivans Drugs Of Mt. Olive

LBN: Ageless Rx Systems Llc
Sullivans Drugs Of Mt. Olive is an health care organization with primary practice located at 107 E Main St Ste D , Mount Olive IL 62069-1703. The organization recently has 2 registered licenses in different health care specialties including 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) 999-3016, or through Allan, Terry via phone (217) 839-2877.

Contact Information

Primary practice address
107 E Main St Ste D Mount Olive IL 62069-1703
Phone: (217) 999-3016
Fax: (217) 999-3020
Website:
Map and Directions
Authorized official contact:
Name: Allan, Terry PHARM.D
Phone: (217) 839-2877

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 054003991 Illinois

Profile Details

NPI number 1871578583
LBN Legal business name Ageless Rx Systems Llc
DBA Doing business as Sullivans Drugs Of Mt. Olive
Authorized official Allan, Terry PHARM.D
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2005
Last updated Jun 7th, 2024 - about 3 months ago

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 1871578583 NPPES
Other 2023241 PK
MEDICAID 370647772002 PK

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