Moweaqua Pharmacy PC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.014967 Issued in IL

Legal business name

MOWEAQUA PHARMACY PC

Doing business as

Moweaqua Pharmacy

Practice address

620 N Putnam St
Moweaqua, IL 62550-9482

Phone

(217) 768-3832

Fax

(217) 768-3077

NPI assigned

May 11, 2006

Last updated

Feb 20, 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

Terry Traster, PHARMD

Title

Owner

Phone

(217) 768-3832

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MOWEAQUA PHARMACY Doing business as

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1407806607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N PUTNAM ST",
            "city": "MOWEAQUA",
            "state": "IL",
            "postal_code": "625509482",
            "telephone_number": "217-768-3832",
            "fax_number": "217-768-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PUTNAM ST",
            "city": "MOWEAQUA",
            "state": "IL",
            "postal_code": "625509482",
            "telephone_number": "217-768-3832",
            "fax_number": "217-768-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOWEAQUA PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "TRASTER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-768-3832",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.014967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2017582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOWEAQUA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberlie Koester-Bender
• Brian J McGregor, D.C.
• Messamore Family Chiropractic LTD
• Moweaqua Community Ambulance Service
• Moweaqua Family Practice Center, LTD
• Moweaqua Rehabilitation & Health Care Center, LLC (Moweaqua Rehabilitation & Health Care Center)
• Holly Olivio, MS, RDN, LDN, CNSC
• Larry Don Page, DMD
• Sloan Jane Sloan
• Springfield Clinic LLP (Springfield Clinic Moweaqua Lab)

• Community/Retail Pharmacy in Moweaqua, IL
• Providers in Moweaqua, 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 Feb 20, 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.