NPI 1114478500 · live from the CMS NPI Registry
5 Guys Rx Ii LLC
Pharmacy, Community/Retail Pharmacy in Charleston, IL. National Provider Identifier 1114478500, active.
NPI record
| NPI | 1114478500 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 1 W Lincoln Ave, Charleston, IL 61920 |
| Practice phone | 217-512-2816 |
| Mailing address | 913 Northwood Dr, Effingham, IL 62401 |
| Enumerated | October 20, 2016 |
| Last updated | August 14, 2024 |
| Authorized official | Tal Rozene, President |
| Other names | Wellcreek Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | 054.020171 (IL) |
| Pharmacy, Long Term Care Pharmacy | 3336L0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.