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Extended Pharmacy Llc
Long Term Care Pharmacy in Peoria, Illinois
NPI 1700014446

Extended Pharmacy Llc is a Long Term Care Pharmacy based in Peoria, IL and is specialized in Long Term Care Pharmacy. Extended Pharmacy Llc practices in Peoria, IL. The NPI Number for Extended Pharmacy Llc is 1700014446 and holds a License No. 64002202A (Illinois).

The current practice location address for Extended Pharmacy Llc is 121 State St Ste 1A, Peoria, IL and can be reached out via phone at 309-676-4831 and via fax at 309-676-7014. You can also correspond with Extended Pharmacy Llc through the mailing address at 121 STATE ST STE 1A, PEORIA, IL - 61602-1547 (mailing address contact number: 309-676-4831).

Location: 121 State St Ste 1A, Peoria, IL, 61602-1547
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700014446
Provider Name
Extended Pharmacy Llc
Credential
Provider Entity Type
Organization
Address
121 State St Ste 1A, Peoria, IL, 61602-1547
Phone Number
309-676-4831
Fax Number
309-676-7014
Provider Enumeration Date
07/01/2009
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2120962 01 PK
institution
Provider Business Practice Location Address Details
Address
121 State St Ste 1A
City
Peoria
State
Illinois
Zip
61602-1547
Phone Number
309-676-4831
Fax Number
309-676-7014
person
Provider Business Mailing Address Details
Address
121 State St Ste 1A
City
Peoria
State
Illinois
Zip
61602-1547
Phone Number
309-676-4831
Fax Number
309-676-7014
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
054016704 (Illinois)
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
64002202A (Indiana)
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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