NPIMap

Organization Active NPI

Illinois Department of Human

Doing business as DHS Central Outpatient Pharmacy

  • Mail Order Pharmacy
  • Springfield, IL
National Provider Identifier
1255462156
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
054014602 Issued in IL
Legal business name
ILLINOIS DEPARTMENT OF HUMAN
Doing business as
DHS Central Outpatient Pharmacy
Practice address
901 Southwind Dr
Springfield, IL 62703-5125
Phone
(217) 558-0965
Fax
(217) 558-2532
NPI assigned
Mar 9, 2007
Last updated
Feb 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Mark Katauski
Title
Dir of PHRM
Phone
(217) 786-6982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X 054014602 IL Primary

Addresses

Primary practice location

901 Southwind Dr
Springfield, IL 62703-5125

Mailing address

901 Southwind Dr
Springfield, IL 62703-5125

Other identifiers 1

IdentifierTypeStateIssuer
1480590OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • DHS CENTRAL OUTPATIENT PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4267292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1255462156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SOUTHWIND DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SOUTHWIND DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035125",
            "telephone_number": "217-558-0965",
            "fax_number": "217-558-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "KATAUSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIR OF PHRM",
        "authorized_official_telephone_number": "217-786-6982"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "IL",
            "license": "054014602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1480590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DHS CENTRAL OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.