Illinois Department of Human Services
Organization
Active NPI
Long Term Care Pharmacy · Anna, IL
NPI 1154475986 · NPPES record last updated Dec 7, 2022
Key facts
- NPI
- 1154475986
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- 054017322 (IL)
- Legal business name
- ILLINOIS DEPARTMENT OF HUMAN SERVICES
- Practice address
- 1000 N Main St
Anna, IL 62906-1652
- Phone
- (618) 833-5161
- Fax
- (618) 833-3432
- NPI assigned
- Jan 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Catherine Onstott, RPH
- Title
- Pharmacy Manager
- Phone
- (618) 202-6708
Corporate family (same tax ID) 24
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National Provider Directory
- Tax ID family
- Howe Center - Unit 4264 (292 organizations share this tax ID)
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Pharmacy |
333600000X |
|
|
|
| Long Term Care Pharmacy |
3336L0003X |
054017322 |
IL |
Yes |
Addresses
Primary practice location
1000 N Main St
Anna, IL 62906-1652
Mailing address
1000 N Main St
Anna, IL 62906-1652
Phone (618) 833-5161
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 2023357 | Other | | PK |
Other names
- CLYDE CHOATE MENTAL HEALTH DEVELOPMENTAL CENTER Doing business as