Active NPI
Mercer County Hospital Pharmacy
- Institutional Pharmacy
- Aledo, IL
National Provider Identifier
1205924024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Institutional Pharmacy
- Legal business name
- MERCER COUNTY HOSPITAL PHARMACY
- Practice address
- 409 N.W. 9TH Ave
Pharmacy
Aledo, IL 61231 - Phone
- (309) 582-5301
- Fax
- (309) 582-3737
- NPI assigned
- Oct 10, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tim Putnam
- Title
- Ceo
- Phone
- (309) 582-5301
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Institutional Pharmacy | 3336I0012X | IL | Primary |
Addresses
Primary practice location
409 N.W. 9TH Ave
Pharmacy
Aledo, IL 61231
Mailing address
409 N.W. 9TH Ave
Aledo, IL 61231
Phone (309) 582-5301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1452755 | Other | IL | NCPDP |
National Provider Directory
National Provider Directory- Tax ID family
- County of Mercer Hospital
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Mercer County Hospital Outpatient Pharmacy
- Community/Retail Pharmacy
- Aledo, IL
- NPI 1912091745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1205924024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 N.W. 9TH AVE",
"city": "ALEDO",
"state": "IL",
"postal_code": "61231",
"telephone_number": "309-582-5301",
"fax_number": "309-582-3737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 N.W. 9TH AVE",
"address_2": "PHARMACY",
"city": "ALEDO",
"state": "IL",
"postal_code": "61231",
"telephone_number": "309-582-5301",
"fax_number": "309-582-3737"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCER COUNTY HOSPITAL PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PUTNAM",
"authorized_official_first_name": "TIM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "309-582-5301"
},
"taxonomies": [
{
"code": "3336I0012X",
"taxonomy_group": "",
"desc": "Pharmacy, Institutional Pharmacy",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1452755",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aledo, IL
- Janice R Klink, OCCUPATIONAL THERAPI
- Jesse George Korns
- Allison Jean Linder, DC
- McKnight Pharmacy
- Mercer County Family Young Men's Christian Association of Aledo, Illin
- Mercer County Nursing Home
- Mercer County School Dist 404
- Mercer Cty Hospital (Mercer County Hospital Outpatient Pharmacy)
- Mercer Health Center, S.C.
- Mercer Manor Rehabilitation LLC
Sources for this page
- 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.