Potter Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054006072 Issued in IL

Legal business name

POTTER PHARMACY INC

Doing business as

Potter Drug Inc

Practice address

200 S 6TH St
Petersburg, IL 62675-1553

Phone

(217) 632-2287

Fax

(217) 632-2033

NPI assigned

Nov 9, 2005

Last updated

Mar 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Potter

Title

President

Phone

(217) 632-2288

Specialties & licenses 2

Addresses

Other names 1

• POTTER DRUG INC Doing business as

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1073594859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626750498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 6TH ST",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626751553",
            "telephone_number": "217-632-2287",
            "fax_number": "217-632-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-632-2288"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054006072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POTTER DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David D Newton, M.D.
• Dana Yvette Ogle, PTA
• Petersburg Pharmacy, Inc
• Petersburg Spine & Sport Inc (Petersburg Spine & Sport)
• Porta Comm. Unit District 202
• Emilie J Redding, M.D.
• Delores J Ring, LCPC
• Ashley Nichol Sanders
• Brianne Satorius
• Bree A Schmulbach, APN

• Community/Retail Pharmacy in Petersburg, IL
• Providers in Petersburg, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.