Provider Demographics
NPI:1063015709
Name:ABELL, CHARLES GREGORY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GREGORY
Last Name:ABELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 SADDLEBROOK ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-2453
Mailing Address - Country:US
Mailing Address - Phone:812-890-4779
Mailing Address - Fax:
Practice Address - Street 1:1325 W 9TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-2906
Practice Address - Country:US
Practice Address - Phone:618-263-9101
Practice Address - Fax:618-263-9104
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028959A183500000X
IL051.292672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist