Vernon Andersen Inc
Organization Active NPI Community/Retail Pharmacy · Bethalto, IL
NPI 1407867906 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1407867906
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- VERNON ANDERSEN INC
- Practice address
- 341 W Bethalto Dr
Bethalto, IL 62010-1779 - Phone
- (618) 377-5356
- Fax
- (618) 377-0159
- NPI assigned
- Aug 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Vernon Eugene Andersen, RPH
- Title
- President
- Phone
- (618) 377-5356
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 054014647 | IL | |
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
341 W Bethalto Dr
Bethalto, IL 62010-1779
Mailing address
341 W Bethalto Dr
Bethalto, IL 62010-1779
Phone (618) 377-5356
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364151335001 | Medicaid | IL | |
| 1467631 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- MEDICINE SHOPPE PHARMACY
Other providers in Bethalto, IL
- Supporting Community Independence
- Debra J Taylor
- Team Physical Therapy
- Team Physical Therapy, LLC
- Uptown Emergency Physicians LLP
- Billie Vincent
- Walgreen Co
- Ashley Dawn Weant
- Mallory Scrivner Welch
- Alan Joseph Wickenhauser
All providers in Bethalto, 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 7, 2023. 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.