Organization · Type 2 NPI
Extended Pharmacy LLC
Long Term Care Pharmacy · Peoria, IL
NPI number
1700014446
Active
Practice location
121 State St Ste 1A
Peoria, IL 61602-1547
Fax (309) 676-7014
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | 64002202A (IN) |
| Long Term Care Pharmacy Primary | 3336L0003X | 054016704 (IL) |
| Long Term Care Pharmacy | 3336L0003X | 2015044792 (MO) |
Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Other long term care pharmacy providers in Peoria
About NPI 1700014446
Extended Pharmacy LLC's National Provider Identifier is 1700014446, issued on Jul 1, 2009. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Peoria, IL. The record was last updated on Mar 14, 2023.