Active NPI
Axline's Inc.
- Community/Retail Pharmacy
- Roseville, IL
National Provider Identifier
1255344883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 54009192
- Legal business name
- AXLINE'S INC.
- Practice address
- 125 N Main St
Roseville, IL 61473-9574 - Phone
- (309) 426-2954
- Fax
- (309) 426-2565
- NPI assigned
- Aug 14, 2006
- Last updated
- Mar 10, 2022
- 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
- Troy L Williams, RPH
- Title
- Owner/RPH
- Phone
- (309) 734-5196
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 54009192 | IL | Primary |
Addresses
Primary practice location
125 N Main St
Roseville, IL 61473-9574
Mailing address
220 N Main St
Monmouth, IL 61462-1741
Phone (309) 734-5196
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1432195 | Other | NCPDP NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- Axline Advanced
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Bloomington, IL
- NPI 1215237359
-
dba Flanagan Health Mart Pharmacy
- Community/Retail Pharmacy
- Flanagan, IL
- NPI 1376593483
Locations
125 N Main St
Roseville, IL 61473
Phone (309) 426-2954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646870400000",
"number": "1255344883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 N MAIN ST",
"city": "MONMOUTH",
"state": "IL",
"postal_code": "614621741",
"telephone_number": "309-734-5196",
"fax_number": "309-734-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 N MAIN ST",
"city": "ROSEVILLE",
"state": "IL",
"postal_code": "614739574",
"telephone_number": "309-426-2954",
"fax_number": "309-426-2565"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AXLINE'S INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-14",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "TROY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER/RPH",
"authorized_official_telephone_number": "309-734-5196",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IL",
"license": "54009192",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP NUMBER",
"identifier": "1432195",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.