NPIMap

Organization Active NPI

Sharshon Pharmacy. Inc.

  • Community/Retail Pharmacy
  • Peoria Heights, IL
National Provider Identifier
1003986019
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054016379 Issued in IL
Legal business name
SHARSHON PHARMACY. INC.
Practice address
4600 N. Prospect Rd.
Suite 2
Peoria Heights, IL 61616
Phone
(309) 688-3684
Fax
(309) 688-5947
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Walter Sharshon
Title
Owner
Phone
(630) 210-5307

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054016379 IL Primary
Long Term Care Pharmacy 3336L0003X 054016379 IL

Addresses

Primary practice location

4600 N. Prospect Rd.
Suite 2
Peoria Heights, IL 61616

Mailing address

931 W Galena Blvd
Aurora, IL 60506-3751
Phone (309) 688-3684

Other names 1

  • Smith Easy Care Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sharshon Pharmacy Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4600 N Prospect Rd
Peoria Heights, IL 61616
Phone (309) 688-3684

4600 N Prospect Rd
Ste 2
Peoria Heights, IL 61616
Phone (309) 688-3684

4700 N Prospect Rd
Peoria Hts, IL 61616
Phone (309) 682-3915

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520208000000",
    "number": "1003986019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063751",
            "telephone_number": "309-688-3684",
            "fax_number": "390-688-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N. PROSPECT RD.",
            "address_2": "SUITE 2",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "61616",
            "telephone_number": "309-688-3684",
            "fax_number": "309-688-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARSHON PHARMACY. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-03-05",
        "status": "A",
        "authorized_official_last_name": "SHARSHON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-210-5307"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016379",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054016379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Easy Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.