Goslin Drug Store Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GOSLIN DRUG STORE INC

Practice address

1212 13TH Ave
Mendota, IL 61342

Phone

(815) 538-4761

Fax

(815) 539-5876

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Herbert Allen Goslin, RPH

Title

President

Phone

(815) 538-4761

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114022589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 13TH AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "61342",
            "telephone_number": "815-538-4761",
            "fax_number": "815-539-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 13TH AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "61342",
            "telephone_number": "815-538-4761",
            "fax_number": "815-539-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSLIN DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOSLIN",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-538-4761",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rose Ford, CRNA
• Forest City Behavior LLC
• Alicia Foster
• Marissa Gatza, C.O.T.A.
• Kristi Gonzales, PA-C
• Pamela A Hansen, PA-C
• Heritage Manor - Mendota, LLC
• Heritage Manor Mendota, LLC
• Highland Park CVS, L.L.C.
• Ashlee Hoff, OTR

• Pharmacy in Mendota, IL
• Providers in Mendota, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.