Provider Demographics
NPI:1568471316
Name:ECONOMY PHARMACY, INC.
Entity Type:Organization
Organization Name:ECONOMY PHARMACY, INC.
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUDDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-281-5135
Mailing Address - Street 1:134 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:IL
Mailing Address - Zip Code:62236-2306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2306
Practice Address - Country:US
Practice Address - Phone:618-281-5135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.0136783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1467845OtherNCPDP #
ILP0041739OtherMEDICARE RAILROAD #
ILP0041739OtherMEDICARE RAILROAD #
ILP0041739OtherMEDICARE RAILROAD #
IL=========001Medicaid
ILBE5731143OtherDEA #