Provider Demographics
NPI:1356844526
Name:PHARMACY PLUS INC
Entity Type:Organization
Organization Name:PHARMACY PLUS INC
Other - Org Name:PHARMACY PLUS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-248-6868
Mailing Address - Street 1:315 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:IL
Mailing Address - Zip Code:62640-1111
Mailing Address - Country:US
Mailing Address - Phone:217-627-9999
Mailing Address - Fax:217-627-2930
Practice Address - Street 1:315 W CENTER ST
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:IL
Practice Address - Zip Code:62640
Practice Address - Country:US
Practice Address - Phone:217-627-9999
Practice Address - Fax:217-627-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
IL054.0206743336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176513OtherPK
2176513OtherPK