Provider Demographics
NPI:1285668830
Name:ST. JOSEPH DRUGS, INC
Entity Type:Organization
Organization Name:ST. JOSEPH DRUGS, INC
Other - Org Name:ST. JOSEPH APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNDAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, FACA
Authorized Official - Phone:217-469-2232
Mailing Address - Street 1:204 N. MAIN
Mailing Address - Street 2:
Mailing Address - City:ST. JOSEPH
Mailing Address - State:IL
Mailing Address - Zip Code:61873-0500
Mailing Address - Country:US
Mailing Address - Phone:217-469-2232
Mailing Address - Fax:217-469-2381
Practice Address - Street 1:204 N. MAIN
Practice Address - Street 2:
Practice Address - City:ST. JOSEPH
Practice Address - State:IL
Practice Address - Zip Code:61873-0500
Practice Address - Country:US
Practice Address - Phone:217-469-2232
Practice Address - Fax:217-469-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1427726OtherNABP
IL=========002Medicaid