Provider Demographics
NPI:1295078137
Name:PHARMACY PLUS, INC.
Entity type:Organization
Organization Name:PHARMACY PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:217-942-3427
Mailing Address - Street 1:116 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:IL
Mailing Address - Zip Code:62092-1054
Mailing Address - Country:US
Mailing Address - Phone:217-374-2222
Mailing Address - Fax:217-374-2220
Practice Address - Street 1:116 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:IL
Practice Address - Zip Code:62092-1054
Practice Address - Country:US
Practice Address - Phone:217-374-2222
Practice Address - Fax:217-374-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540181473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054018147OtherILLINOIS PHARMACY LICENSE