Extended Living Pharmacy LLC

NPI #1992899306 in Forsyth, Illinois

Provider Information

NPI Number: 1992899306
Entity Type: Organization
Organization Name: Extended Living Pharmacy LLC
Primary Specialty: Pharmacy - Long Term Care Pharmacy
Enumeration Date: Oct 3, 2006
Last Updated: Mar 13, 2019

Practice Location

Address: 338 W MARION AVE
City: Forsyth
State: Illinois
ZIP Code: 62535-1064
Phone: (217) 875-7147

Authorized Official

Name: JEFFREY AUBRY, RPH
Title: MANAGER
Phone: (217) 855-8378

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Pharmacy - Long Term Care Pharmacy — Long Term Care Pharmacy	3336L0003X	Primary

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