Carlinville Health & Prescription Services
Organization Active NPI Pharmacy · Carlinville, IL
NPI 1265417281 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1265417281
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 545698 (IL)
- Legal business name
- CARLINVILLE HEALTH & PRESCRIPTION SERVICES
- Practice address
- 920 W Main St
Carlinville, IL 62626-1200 - Phone
- (217) 854-6121
- Fax
- (217) 854-6131
- NPI assigned
- Dec 13, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Owen P Sullivan, RPH
- Title
- Owner/Pharmacist
- Phone
- (217) 854-6121
Other NPIs on the same Medicare enrollment 1
Practitioners 1
-
Owen P Sullivan, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930057898 | IL | DME Supplier - Pharmacy | 1951420314 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Carlinville, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 545698 | IL | Yes |
Addresses
Primary practice location
920 W Main St
Carlinville, IL 62626-1200
Mailing address
920 W Main St
Carlinville, IL 62626-1200
Phone (217) 854-6121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 545698 | Other | IL | PHARMACY LISCENSE NUMBER |
Other names
- Sullivan Drugs
Other providers in Carlinville, IL
- Carlinville Area Hospital Association
- Carlinville Area Hospital Association
- Carlinville Chiropractic Clinic LTD
- Carlinville Community Unit School District #1
- Carlinville Eye Care PC
- Carlinville Health & Prescriptions Services Inc
- Carlinville Medical Clinic, Inc.
- Carlinville Medical Clinic, Inc.
- Carlinville Rehabilitation and Health Care Center, LLC
- Carlinville Senior Living LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.