Provider Demographics
NPI:1063976033
Name:VOGEL'S COMPOUNDING PHARMACY PLLC
Entity type:Organization
Organization Name:VOGEL'S COMPOUNDING PHARMACY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:217-781-0901
Mailing Address - Street 1:137 NORTH MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:IL
Mailing Address - Zip Code:60957
Mailing Address - Country:US
Mailing Address - Phone:217-781-0901
Mailing Address - Fax:
Practice Address - Street 1:137 NORTH MARKET STREET
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:IL
Practice Address - Zip Code:60957
Practice Address - Country:US
Practice Address - Phone:217-781-0901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty