Mallex Corporation
Community/Retail Pharmacy
400a W Carpenter St, Jerseyville
Illinois, 62052-2522
618-498-6461 618-639-9450
Mallex Corporation is a Community/Retail Pharmacy in Jerseyville, Illinois. It is located at 400a W Carpenter St, Jerseyville and it's customer support contact number is 618-498-6461. The authorized person of Mallex Corporation is Ethan Vandersand who is President of the pharmacy and his contact number is 618-498-6461. Active license number of Mallex Corporation is 054.018000 for Community/Retail Pharmacy in Illinois. Mallex Corporation accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Mallex Corporation is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Mallex Corporation type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Mallex Corporation |
| Type: | Community/Retail Pharmacy |
| Location: | 400a W Carpenter St, Jerseyville,
Illinois, 62052-2522 |
| Phone: | 618-498-6461 |
| Fax: | 618-639-9450 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Ethan Vandersand |
| Position: | President |
| Contact Number: | 618-498-6461 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1023363025 |
| NPI Enumeration Date: | 17 Jul, 2012 |
| NPI Last Update On: | 05 Jul, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mallex Corporation are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 054.018000 | Illinois | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2137095 | Other | | Pk |
Medicare Enrollment:
Mallex Corporation is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6305083932 | O20130520000012 | Mallex Corporation | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 400a W Carpenter St,
Jerseyville, Illinois |
| Zip: | 62052-2522 |
| Phone Number: | 618-498-6461 |
| Fax Number: | 618-639-9450 |
Patients can reach Mallex Corporation at
400a W Carpenter St, Jerseyville, Illinois or can
call on customer care at 618-498-6461.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.