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Contact Information

GARDNER PHARMACY INC
122 DEPOT
GARDNER, IL60424
 Phone: 815-237-2152
 Fax: 815-237-0858
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GARDNER PHARMACY INC

NPI Number 1154418499
LBN Legal business name GARDNER PHARMACY INC
Authorized official CURT TRIZZINO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/06/2006
Last updated 11/28/2007 - About 19 years ago
Identifiers
IL Medicaid 363771367001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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