Provider Demographics
NPI:1821476300
Name:JAY MCHUGH
Entity Type:Organization
Organization Name:JAY MCHUGH
Other - Org Name:MCHUGH DRUG STORR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-357-2623
Mailing Address - Street 1:70 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-1331
Mailing Address - Country:US
Mailing Address - Phone:217-357-2623
Mailing Address - Fax:217-357-9515
Practice Address - Street 1:70 S MADISON ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-1331
Practice Address - Country:US
Practice Address - Phone:217-357-2623
Practice Address - Fax:217-357-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.0136083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy