Benner Family Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Ottawa, IL

NPI 1467515080 · NPPES record last updated Nov 20, 2009

Key facts

NPI
1467515080
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
054016665 (IL)
Legal business name
BENNER FAMILY PHARMACY INC
Practice address
1614 E Norris Dr
Ottawa, IL 61350-3681
Phone
(815) 433-4666
Fax
(815) 433-4719
NPI assigned
Dec 18, 2006
Organization subpart
No

Authorized official

Name
John Groesbeck
Title
President
Phone
(815) 434-5355

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054016665 IL Yes

Addresses

Primary practice location

1614 E Norris Dr
Ottawa, IL 61350-3681

Mailing address

1614 E Norris Dr
Ottawa, IL 61350-3681
Phone (815) 433-4666

Other identifiers

IdentifierTypeStateIssuer
1460233OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names

  • THE PHARMACY STOP MEDICAL CENTER Doing business as

Other providers in Ottawa, IL

All providers in Ottawa, IL · Community/Retail Pharmacy in Illinois

Sources for this page

Verify at the official NPI Registry.