5 Guys RX II LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.020171 Issued in IL

Legal business name

5 GUYS RX II LLC

Doing business as

Wellcreek Pharmacy

Practice address

1 W Lincoln Ave
Charleston, IL 61920

Phone

(217) 512-2816

Fax

(844) 512-2573

NPI assigned

Oct 20, 2016

Last updated

Aug 14, 2024By 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

Mr. Tal RozeneNPI 1205168481

Title

President

Phone

(217) 994-1496

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Wellcreek Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tal M Rozene, RPH

  • Pharmacist
  • Effingham, IL
  • NPI 1205168481
  NPD (past) Authorized official
• Robert Goodhue Jr., PHARMD

  • Pharmacist
  • Paradise Valley, AZ
  • NPI 1548687593
  NPD

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1114478500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 NORTHWOOD DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624015206",
            "telephone_number": "217-512-2816",
            "fax_number": "217-512-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-512-2816",
            "fax_number": "844-512-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 GUYS RX II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "ROZENE",
        "authorized_official_first_name": "TAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-994-1496",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "054.020171",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168642",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcreek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A William G Schubert MD LTD
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• Alyssa Ailey, MS, RD, LDN
• Chelsea Kay Allen-Labaume, M.S., LCPC

• Community/Retail Pharmacy in Charleston, IL
• Providers in Charleston, 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 Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.