Byrd-Watson South 9TH Drug Co

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

BYRD-WATSON SOUTH 9TH DRUG CO

Practice address

1200 Main St
Mount Vernon, IL 62864-3821

Phone

(618) 242-2800

Fax

(618) 244-4816

NPI assigned

Oct 6, 2005

Organization subpart

No

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

Authorized official

Name

Adam Breeze

Title

Officer of the Corporation

Phone

(618) 244-5400

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Byrd-Watson Medical Downtown Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Dale McBride, PHARM.D.

  • Pharmacist
  • Mount Vernon, IL
  • NPI 1346580669
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1437147246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1179",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628640024",
            "telephone_number": "618-242-2800",
            "fax_number": "618-242-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAIN ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628643821",
            "telephone_number": "618-242-2800",
            "fax_number": "618-244-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRD-WATSON SOUTH 9TH DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "BREEZE",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OFFICER OF THE CORPORATION",
        "authorized_official_telephone_number": "618-244-5400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "140146",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "4132044",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "177625",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Byrd-Watson Medical Downtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Ann Burke, MSW LCSW CADC MISAII
• Nicholas Antonio Burke
• Derek Burns, PHARMD
• Michelle Burwell, PA-C
• Patricia Claire Butler
• Byrd-Watson Times Square Drug Co
• Byrd-Watson Times Square Drug Co
• Thomas J. Cain, CRNA
• Patricia Isabel Calcetto, CRNA
• Hannah Capps, MHP

• Oxygen Equipment & Supplies (DME) in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.