Maurice E Sullivan

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054007502 Issued in IL

Legal business name

MAURICE E SULLIVAN

Doing business as

Sullivan Drug of Raymond

Practice address

801 N Obannon St
Raymond, IL 62560-5283

Phone

(217) 229-3022

Fax

(217) 229-3065

NPI assigned

Dec 19, 2005

Last updated

Feb 16, 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

Maurice Sullivan, R.PH.NPI 1770508749

Title

Owner

Phone

(217) 839-2909

Specialties & licenses 3

Addresses

Other names 1

• SULLIVAN DRUG OF RAYMOND Doing business as

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.

• Maurice E Sullivan, R. PH.

  • Pharmacist
  • Raymond, IL
  • NPI 1770508749
  Authorized official Same address or phone

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1477539732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 588",
            "city": "RAYMOND",
            "state": "IL",
            "postal_code": "625600588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N OBANNON ST",
            "city": "RAYMOND",
            "state": "IL",
            "postal_code": "625605283",
            "telephone_number": "217-229-3022",
            "fax_number": "217-229-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICE E SULLIVAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-839-2909",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054007502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SULLIVAN DRUG OF RAYMOND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Deborah Kay Langham, REGISTERED NURSE
• Lincoln Recovery LLC
• Panhandle Cusd 2
• Raymond Harvel Area Ambulance Service
• Springfield Clinic LLP
• Maurice E Sullivan, R. PH.
• Sunshine Behavioral Health Group LLC (Lincoln Recovery LLC)

• Community/Retail Pharmacy in Raymond, IL
• Providers in Raymond, 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 16, 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.