Dolan Central Illinois Compounding Pharmacy LLC

NPI #1568970556 in Peoria, Illinois

Provider Information

NPI Number
1568970556
Entity Type
Organization
Organization Name
Dolan Central Illinois Compounding Pharmacy LLC
Primary Specialty
Pharmacist
Enumeration Date
Jan 12, 2018
Last Updated
Mar 19, 2018

Practice Location

Address
5832 N KNOXVILLE AVE STE E
City
Peoria
ZIP Code
61614-4304
Phone
(309) 679-2047

Authorized Official

Name
COREY DOLAN, PHARM D
Title
OWNER/PHARMACY MANAGER
Phone
(309) 679-2047

Specialties & Taxonomy Codes

Specialty
Pharmacist

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