Organization Active NPI

Evers Pharmacy Inc

Doing business as Dauber Pharmacy

  • Pharmacy
  • Mascoutah, IL
National Provider Identifier
1114970688
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
054014644 Issued in IL
Legal business name
EVERS PHARMACY INC
Doing business as
Dauber Pharmacy
Practice address
16 E Main St
Mascoutah, IL 62258
Phone
(618) 566-8521
Fax
(618) 566-8318
NPI assigned
May 18, 2006
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
William Whitworth, RPH
Title
Owner
Phone
(618) 343-2525

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Pharmacy 333600000X 054014644 IL Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

16 E Main St
Mascoutah, IL 62258

Mailing address

16 E Main St
Mascoutah, IL 62258
Phone (618) 566-8521

Other names 1

  • Dauber Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930097788 IL DME Supplier - Pharmacy 1153449327 Practice locations: Mascoutah, IL
O20250305002376 IL Part B Supplier - Pharmacy 1153449327 Practice locations: Mascoutah, IL

National Provider Directory

National Provider Directory

Locations

16 E Main St
Mascoutah, IL 62258
Phone (618) 566-8521

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1114970688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "62258",
            "telephone_number": "618-566-8521",
            "fax_number": "618-566-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "62258",
            "telephone_number": "618-566-8521",
            "fax_number": "618-566-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "WHITWORTH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-343-2525",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054014644",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dauber Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dauber Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mascoutah, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.