Potter Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Petersburg, IL
NPI 1073594859 · NPPES record last updated Mar 6, 2014
Key facts
- NPI
- 1073594859
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 054006072 (IL)
- Legal business name
- POTTER PHARMACY INC
- Practice address
- 200 S 6TH St
Petersburg, IL 62675-1553 - Phone
- (217) 632-2287
- Fax
- (217) 632-2033
- NPI assigned
- Nov 9, 2005
- Organization subpart
- No
Authorized official
- Name
- Patrick Potter
- Title
- President
- Phone
- (217) 632-2288
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 054006072 | IL | Yes |
Addresses
Primary practice location
200 S 6TH St
Petersburg, IL 62675-1553
Mailing address
PO Box 498
Petersburg, IL 62675-0498
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2023312 | Other | PK |
Other names
- POTTER DRUG INC
Other providers in Petersburg, IL
- David D Newton
- Dana Yvette Ogle
- Petersburg Pharmacy, Inc
- Petersburg Spine & Sport Inc
- Porta Comm. Unit District 202
- Emilie J Redding
- Delores J Ring
- Ashley Nichol Sanders
- Brianne Satorius
- Bree A Schmulbach
All providers in Petersburg, IL · Community/Retail Pharmacy in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.