Maurice E Sullivan
Pharmacy, Community/Retail Pharmacy in Raymond, IL. Organization (NPI-2).
NPI number1477539732
StatusActive
Last updated in NPPESFeb 16, 2017
Details
- NPI
- 1477539732
- Entity type
- Organization (NPI-2)
- Legal business name
- Maurice E Sullivan
- Organization subpart
- No
- Enumeration date
- Dec 19, 2005
- Last updated
- Feb 16, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 054007502 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Sullivan Drug Of Raymond (Doing Business As)
Practice location
801 N Obannon StRaymond, IL 62560-5283
Phone 217-229-3022 · Fax 217-229-3065
Mailing address
Po Box 588Raymond, IL 62560-0588
Authorized official
Maurice Sullivan
Owner
2178392909
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