NPIMap

Organization Active NPI

Axline's Inc.

Doing business as Flanagan Health Mart Pharmacy

  • Community/Retail Pharmacy
  • Flanagan, IL
National Provider Identifier
1376593483
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054-018165 Issued in IL
Legal business name
AXLINE'S INC.
Doing business as
Flanagan Health Mart Pharmacy
Practice address
116 S Main St
Flanagan, IL 61740-7536
Phone
(815) 796-2274
Fax
(815) 796-3277
NPI assigned
May 11, 2006
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Troy WilliamsNPI 1760099899
Title
Owner/RPH
Phone
(309) 828-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054-018165 IL Primary

Addresses

Primary practice location

116 S Main St
Flanagan, IL 61740-7536

Mailing address

PO Box 1087
Bloomington, IL 61702-1087
Phone (309) 828-6767

Other identifiers 1

IdentifierTypeStateIssuer
1453668OtherILNCPDP

Other names 1

  • Flanagan Health Mart Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Axline Advanced7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

116 S Main St
Flanagan, IL 61740
Phone (815) 796-2274

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1376593483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1087",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617021087",
            "telephone_number": "309-828-6767",
            "fax_number": "309-828-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S MAIN ST",
            "city": "FLANAGAN",
            "state": "IL",
            "postal_code": "617407536",
            "telephone_number": "815-796-2274",
            "fax_number": "815-796-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXLINE'S INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "OWNER/RPH",
        "authorized_official_telephone_number": "309-828-6767"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054-018165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1453668",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flanagan Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flanagan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.