NPIMap

Organization Active NPI

Shawnee Health Service & Development Corp

Doing business as Shawnee Health Pharmacy, Carterville

  • Pharmacy
  • Carterville, IL
National Provider Identifier
1255242764
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SHAWNEE HEALTH SERVICE & DEVELOPMENT CORP
Doing business as
Shawnee Health Pharmacy, Carterville
Practice address
1006 S Division St Ste 200
Carterville, IL 62918-1539
Phone
(618) 519-9200
NPI assigned
Sep 14, 2026
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
David Keith Smiley, RPH
Title
Pharmacy Director
Phone
(618) 519-9200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1006 S Division St Ste 200
Carterville, IL 62918-1539

Mailing address

1006 S Division St Ste 200
Carterville, IL 62918-1539
Phone (618) 519-9200

Other names 1

  • Shawnee Health Pharmacy, Carterville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grand Tower Comm HLTH C37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1255242764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 S DIVISION ST STE 200",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181539",
            "telephone_number": "618-519-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S DIVISION ST STE 200",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181539",
            "telephone_number": "618-519-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE HEALTH SERVICE & DEVELOPMENT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "618-519-9200",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Health Pharmacy, Carterville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carterville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.