NPIMap

Organization Active NPI

Bode Drug Inc

  • Community/Retail Pharmacy
  • Golconda, IL
National Provider Identifier
1417022310
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054018125 Issued in IL
Legal business name
BODE DRUG INC
Doing business as
Bode Drug Inc
Practice address
225 E Main St
Golconda, IL 62938
Phone
(618) 683-3311
Fax
(618) 683-4445
NPI assigned
Nov 24, 2006
Last updated
Jan 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Authorized official

Name
Carl BodeNPI 1912508086
Title
President
Phone
(618) 748-9253

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 054018125 IL Primary

Addresses

Primary practice location

225 E Main St
Golconda, IL 62938

Mailing address

PO Box 364
225 E Main St
Golconda, IL 62938-0364
Phone (618) 683-3311

Other identifiers 1

IdentifierTypeStateIssuer
2139132OtherPK

Other names 1

  • BODE DRUG INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bode Drug Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1417022310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "address_2": "225 E MAIN ST",
            "city": "GOLCONDA",
            "state": "IL",
            "postal_code": "629380364",
            "telephone_number": "618-683-3311",
            "fax_number": "618-683-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E MAIN ST",
            "city": "GOLCONDA",
            "state": "IL",
            "postal_code": "62938",
            "telephone_number": "618-683-3311",
            "fax_number": "618-683-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-748-9253"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054018125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139132",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BODE DRUG INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golconda, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.