Southern Illinois University Student
NPI #1124064035 in Carbondale, Illinois
Provider Information
- NPI Number
- 1124064035
- Entity Type
- Organization
- Organization Name
- Southern Illinois University Student
- Primary Specialty
- Pharmacy - Institutional Pharmacy
- Enumeration Date
- Jun 20, 2006
- Last Updated
- Apr 11, 2016
Practice Location
- Address
- 374 E GRAND AVE
- City
- Carbondale
- State
- Illinois
- ZIP Code
- 62901-3962
- Phone
- (618) 453-4417
Authorized Official
- Name
- SUSAN CHANEY, RPH
- Title
- PHARMACY DIRECTOR
- Phone
- (618) 453-4417
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Institutional Pharmacy — Institutional Pharmacy |
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