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NPI 1194247080

OrganizationActive

11 South Medical Pharmacy, LLC

NPI 1194247080 · Pharmacy · Columbia, IL

Provider details

NPI number: 1194247080
Entity type: Organization
Primary specialty: PharmacySuppliers
Authorized official: Kelsie Lider, Pharmacy Manager
License: 054020346 (IL)

Practice location

1000 Eleven South

Ste 2b

Columbia, IL 62236

Phone: (618) 281-3500

More IL providers

Mailing address

1000 Eleven S Ste 2b

Columbia, IL 62236-1079

Registry dates

Enumerated: 2017-07-12
Last updated: 2017-07-28

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

11 South Medical Pharmacy, LLC — NPI 1194247080, Columbia, IL | NPI Central