Freeburg Pharmacy
LBN: Groceries Of Southern Illinois Llc
Freeburg Pharmacy is an health care organization with primary practice located at 10 Southgate Ctr , Freeburg IL 62243-1541. 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.
Groceries Of Southern Illinois Llc can be contacted via phone (618) 539-5577, or through Schneider, Bryan Victor via phone (618) 207-3186.
Contact Information
Primary practice address
10 Southgate Ctr
Freeburg IL 62243-1541
Phone: (618) 539-5577
Fax: (618) 539-3089
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054009538 | Illinois |
Profile Details
| NPI number | 1528073178 |
|---|---|
| LBN Legal business name | Groceries Of Southern Illinois Llc |
| DBA Doing business as | Freeburg Pharmacy |
| Authorized official | Schneider, Bryan Victor PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Jun 1st, 2022 - about 2 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528073178 | NPPES |
| Other | 2019782 | PK | |
| MEDICAID | 371239582001 | PK |
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