NPIMap

Organization Active NPI

Carlinville Area Hospital Association

  • Institutional Pharmacy
  • Carlinville, IL
National Provider Identifier
1285852772
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
CARLINVILLE AREA HOSPITAL ASSOCIATION
Practice address
20733 N. Broad S
Carlinville, IL 62626
Phone
(217) 854-3141
Fax
(217) 854-9958
NPI assigned
Apr 23, 2007
Reactivated
Dec 11, 2024
Last updated
Dec 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Brian Burnside
Title
President/Ceo
Phone
(217) 854-3141

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 059002948 IL
Institutional Pharmacy 3336I0012X Primary

Addresses

Primary practice location

20733 N. Broad S
Carlinville, IL 62626

Mailing address

20733 N. Broad St
Carlinville, IL 62626
Phone (217) 854-3141

Other identifiers 2

IdentifierTypeStateIssuer
1433224OtherILNABP NUMBER
370345239001MedicaidIL

Other names 1

  • Carlinville Area Hospital Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Carlinville Area Hospit10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1285852772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20733 N. BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-3141",
            "fax_number": "217-854-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20733 N. BROAD S",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-3141",
            "fax_number": "217-854-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLINVILLE AREA HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2024-12-11",
        "certification_date": "2023-02-03",
        "deactivation_date": "2023-02-03",
        "reactivation_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "BURNSIDE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "217-854-3141"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "IL",
            "license": "059002948",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "1433224",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370345239001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlinville Area Hospital Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.