Glen Ed Pharmacy, Llc

LBN: Glen Ed Pharmacy Llc
Glen Ed Pharmacy, Llc is an health care organization with primary practice located at 1 Ginger Creek Mdws , Glen Carbon IL 62034-3508. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Glen Ed Pharmacy Llc can be contacted via phone (618) 655-9898, or through Rieck, David via phone (314) 542-0022.

Contact Information

Primary practice address
1 Ginger Creek Mdws Glen Carbon IL 62034-3508
Phone: (618) 655-9898
Fax: (618) 655-0230
Website:
Map and Directions
Authorized official contact:
Name: Rieck, David
Phone: (314) 542-0022

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 054.018063 Illinois
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1699092122
LBN Legal business name Glen Ed Pharmacy Llc
DBA Doing business as Glen Ed Pharmacy, Llc
Authorized official Rieck, David
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2010
Last updated Mar 12th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699092122 NPPES
Other 1484308 NCPDP PROVIDER IDENTIFICATION NUMBER

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