Byrd-Watson Times Square Drug Co
NPI #1043997182 in Mount Vernon, Illinois
Provider Information
- NPI Number
- 1043997182
- Entity Type
- Organization
- Organization Name
- Byrd-Watson Times Square Drug Co
- Primary Specialty
- Pharmacy - Long Term Care Pharmacy
- Enumeration Date
- Jun 30, 2023
- Last Updated
- Apr 8, 2025
Practice Location
- Address
- 3401 BROADWAY ST
- City
- Mount Vernon
- State
- Illinois
- ZIP Code
- 62864-2201
- Phone
- (618) 244-5400
Authorized Official
- Name
- ADAM BREEZE
- Title
- OFFICER OF THE CORPORATION
- Phone
- (618) 244-5400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Long Term Care Pharmacy — Long Term Care Pharmacy |
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