Hac 4 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054019646 Issued in IL

Legal business name

HAC 4 LLC

Doing business as

The Medicine Shoppe Pharmacy

Practice address

217 S Main St
Farmer City, IL 61842-1455

Phone

(309) 928-2491

Fax

(309) 928-2493

NPI assigned

Dec 15, 2015

Last updated

Apr 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Norma Holtz

Title

Pharmacy Manager

Phone

(309) 928-2491

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Medicine Shoppe Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1265897409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S MAIN ST",
            "city": "FARMER CITY",
            "state": "IL",
            "postal_code": "618421455",
            "telephone_number": "309-928-2491",
            "fax_number": "309-928-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MAIN ST",
            "city": "FARMER CITY",
            "state": "IL",
            "postal_code": "618421455",
            "telephone_number": "309-928-2491",
            "fax_number": "309-928-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAC 4 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "309-928-2491"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054019646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Farmer City Ambulance SRVC Inc
• Farmer City Chiropractic Office P.C.
• Gibson Community Hospital Association (Family Health Clinic of Farmer City)
• Cezario Gutierrez Jr, PT
• H & H Family Dental, PC
• Haven of Farmer City, LLC
• Laurie A Johnston, COTA
• Bobbi S Kennedy
• Kris Erin Knox, ATC
• Mimi Marks, M.T.

• Community/Retail Pharmacy in Farmer City, IL
• Providers in Farmer City, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.