Nauvoo Pharmacy, Pllc
LBN: Nauvoo Pharmacy, Pllc
Nauvoo Pharmacy, Pllc is an health care organization with primary practice located at 1350 Mulholland Street , Nauvoo IL 62354. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Nauvoo Pharmacy, Pllc can be contacted via phone (217) 453-2717, or through Haas, Mattie Ann via phone (217) 453-2717.
Contact Information
Primary practice address
1350 Mulholland Street
Nauvoo IL 62354
Phone: (217) 453-2717
Fax: (217) 453-6456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 054007478 | Illinois |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054007478 | Illinois |
Profile Details
| NPI number | 1205078847 |
|---|---|
| LBN Legal business name | Nauvoo Pharmacy, Pllc |
| DBA Doing business as | |
| Authorized official | Haas, Mattie Ann PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 27th, 2009 |
| Last updated | Feb 17th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205078847 | NPPES |
| Illinois | MEDICAID | 3711031796235401 |
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