National Provider Identifier Database

MARISSA FOOD MART
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

MARISSA FOOD MART
700 E. LYONS ST.
MARISSA, IL62257
Phone: 618-295-2317
Fax: 618-295-2318
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for MARISSA FOOD MART

NPI Number 1003980111
Legal business name
LBN
MARISSA FOOD MART
Authorized official GAIL LASKOWSKI - (SECRETARY OF CORP.)
Entity Organization
Organization subpart Yes
Enumeration date 11/20/2006
Last updated 04/15/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 054.009766
  • IL Other: 054009766 LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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