Provider Demographics
NPI:1205260544
Name:LYNNS FAMILY PHARMACY, P.C.
Entity type:Organization
Organization Name:LYNNS FAMILY PHARMACY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:217-493-6934
Mailing Address - Street 1:1402 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-8002
Mailing Address - Country:US
Mailing Address - Phone:217-762-3377
Mailing Address - Fax:217-762-4499
Practice Address - Street 1:1402 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IL
Practice Address - Zip Code:61856-8002
Practice Address - Country:US
Practice Address - Phone:217-762-3377
Practice Address - Fax:217-762-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy