Active NPI
Promise Healthcare NFP
- Community/Retail Pharmacy
- Champaign, IL
National Provider Identifier
1376384560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PROMISE HEALTHCARE NFP
- Doing business as
- Promise Healthcare Pharmacy
- Practice address
- 819 Bloomington Rd
Champaign, IL 61820-2101 - Phone
- (217) 403-5403
- NPI assigned
- Jun 3, 2024
- 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
- Jennifer Henry
- Title
- Ceo
- Phone
- (217) 403-5401
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
819 Bloomington Rd
Champaign, IL 61820-2101
Mailing address
819 Bloomington Rd
Champaign, IL 61820-2101
Phone (217) 359-1558
Other names 1
- Promise Healthcare Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Promise Healthcare NFP
Other organizations with this tax ID 9
Organizations that report the same tax identification number in the National Provider Directory.
-
- Federally Qualified Health Center (FQHC)
- Urbana, IL
- NPI 1174932586
-
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1043936438
-
- General Practice Dentistry
- Champaign, IL
- NPI 1407005879
-
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1407199391
-
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1588453724
-
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1629828439
-
- Federally Qualified Health Center (FQHC)
- Rantoul, IL
- NPI 1629846928
-
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1801687728
-
- Federally Qualified Health Center (FQHC)
- Urbana, IL
- NPI 1952894180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717372800000",
"number": "1376384560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 BLOOMINGTON RD",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618202101",
"telephone_number": "217-359-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 BLOOMINGTON RD",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618202101",
"telephone_number": "217-403-5403"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROMISE HEALTHCARE NFP",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-03",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A",
"authorized_official_last_name": "HENRY",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "217-403-5401"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Promise Healthcare Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.