Petersburg Pharmacy, Inc
Community/Retail Pharmacy
1 Centre Dr, Suite 100, Petersburg
Illinois, 62675-9467
217-632-7777 217-632-7618
Petersburg Pharmacy, Inc is a Community/Retail Pharmacy in Petersburg, Illinois. It is located at 1 Centre Dr, Suite 100, Petersburg and it's customer support contact number is 217-632-7777. The authorized person of Petersburg Pharmacy, Inc is Mr. David Bagot, RPH who is Pharmacist/owner of the pharmacy and his contact number is 217-632-7777. Active license number of Petersburg Pharmacy, Inc is 054.015430 for Community/Retail Pharmacy in Illinois. Petersburg Pharmacy, Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Petersburg Pharmacy, Inc 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:
Petersburg Pharmacy, Inc 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: | Petersburg Pharmacy, Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 1 Centre Dr, Suite 100, Petersburg,
Illinois, 62675-9467 |
| Phone: | 217-632-7777 |
| Fax: | 217-632-7618 |
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: | Mr. David Bagot |
| Credentials: | RPH |
| Position: | Pharmacist/owner |
| Contact Number: | 217-632-7777 |
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: | 1538259403 |
| NPI Enumeration Date: | 13 Oct, 2006 |
| NPI Last Update On: | 02 Jun, 2015 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Petersburg Pharmacy, Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 054.015430 | 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 |
| 3574-5932 | Other | Illinois | State Id Number |
| 120007769 | Other | Illinois | Medco Provider Number |
| 320.008365 | Other | Illinois | Controlled Sub Lic # |
| 1477745 | Other | Illinois | Nabp Number |
| 054.015430 | Other | Illinois | Div 1 Pharmacy License |
Medicare Enrollment:
Petersburg Pharmacy, Inc 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 |
| 7315157609 | O20100930037449 | Petersburg Pharmacy, Inc | DME SUPPLIER - PHARMACY |
Products Available:
Petersburg Pharmacy, Inc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Orthoses: Off-the-shelf |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1 Centre Dr, Suite 100
Petersburg, Illinois |
| Zip: | 62675-9467 |
| Phone Number: | 217-632-7777 |
| Fax Number: | 217-632-7618 |
Patients can reach Petersburg Pharmacy, Inc at
1 Centre Dr, Suite 100, Petersburg, Illinois or can
call on customer care at 217-632-7777.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.