Potts Family Pharmacy

LBN: Potts Family Llc
Potts Family Pharmacy is an health care organization with primary practice located at 709 W Main St Ste A , Fairfield IL 62837-2312. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Potts Family Llc can be contacted via phone (618) 919-4009, or through Potts, Stephen Dean via phone (618) 919-4009.

Contact Information

Primary practice address
709 W Main St Ste A Fairfield IL 62837-2312
Phone: (618) 919-4009
Fax: (618) 516-8988
Website:
Map and Directions
Authorized official contact:
Name: Potts, Stephen Dean PHARMD.
Phone: (618) 919-4009

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1316681745
LBN Legal business name Potts Family Llc
DBA Doing business as Potts Family Pharmacy
Authorized official Potts, Stephen Dean PHARMD.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 21st, 2022
Last updated Jun 5th, 2024 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316681745 NPPES
Illinois Other 320013673 ILBOP CS
Illinois Other 054022158 ILBOP CS

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