NPI 1003210402

Holistic Pharmacy Service INC

Organisation Pharmacy Springfield, IL

Practice location

Address: 133 N Grand Ave E, Springfield, IL 62702-3859
Phone: (217) 525-0058
Fax: (217) 525-0034

Authorised official

Name: Beaux Cole
Title: Pharmacist
Phone: (217) 525-0058

Registered specialties

Pharmacy Primary

Suppliers Taxonomy 333600000X Licence 054.017739 (IL)

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Registry record

NPI: 1003210402
Entity type: Organization
NPI issued: 14 Oct 2014
Record last updated: 14 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.