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Axline Advanced
Long Term Care Pharmacy in Bloomington, Illinois
NPI 1215237359

Axline Advanced is a Long Term Care Pharmacy based in Bloomington, IL and is specialized in Long Term Care Pharmacy. Axline Advanced practices in Bloomington, IL. The NPI Number for Axline Advanced is 1215237359 and holds a License No. 054-017559 (Illinois).

The current practice location address for Axline Advanced is 1210 Towanda Ave, Bloomington, IL and can be reached out via phone at 309-828-6979 and via fax at 309-828-6977.

Location: 1210 Towanda Ave, Bloomington, IL, 61701-7415
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215237359
Provider Name
Axline Advanced
Credential
Provider Entity Type
Organization
Address
1210 Towanda Ave, Bloomington, IL, 61701-7415
Phone Number
309-828-6979
Fax Number
309-828-6977
Provider Enumeration Date
10/22/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
054-017559 01 IL ILLINOIS LICENSE
1484978 01 IL NCPDP
institution
Provider Business Practice Location Address Details
Address
1210 Towanda Ave
City
Bloomington
State
Illinois
Zip
61701-3454
Phone Number
309-828-6979
Fax Number
309-828-6977
person
Provider Business Mailing Address Details
Address
1210 Towanda Ave
City
Bloomington
State
Illinois
Zip
61701-3454
Phone Number
309-828-6979
Fax Number
309-828-6977
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
054-017559 (Illinois)
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
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