Provider Demographics
NPI:1821557240
Name:TOWN & COUNTRY PHARMACIES, INC.
Entity Type:Organization
Organization Name:TOWN & COUNTRY PHARMACIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-965-4700
Mailing Address - Street 1:132 W MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5816
Mailing Address - Country:US
Mailing Address - Phone:314-965-4700
Mailing Address - Fax:314-965-4706
Practice Address - Street 1:204 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DU QUOIN
Practice Address - State:IL
Practice Address - Zip Code:62832-1805
Practice Address - Country:US
Practice Address - Phone:618-542-2575
Practice Address - Fax:618-542-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054014985OtherSTATE PHARMACY LICENSE