Christie Pharmacy Champaign LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054016506 Issued in IL

Legal business name

CHRISTIE PHARMACY CHAMPAIGN LLC

Doing business as

Christie Pharmacy Champaign LLC

Practice address

101 W University Ave
Champaign, IL 61820-3909

Phone

(217) 366-1278

Fax

(217) 366-6897

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dave Dummler

Title

Pharmacy Manager

Phone

(217) 366-1278

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Christie Pharmacy Champaign LLC Doing business as

Tax ID family

Christie Pharmacy Champaign LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Christie Pharmacy Champaign, LLC

  • Pharmacist
  • Champaign, IL
  • NPI 1245325323
  NPD tax ID

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1487749560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1278",
            "fax_number": "217-366-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1278",
            "fax_number": "217-366-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIE PHARMACY CHAMPAIGN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "DUMMLER",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "217-366-1278"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370802668003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1413878",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christie Pharmacy Champaign LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christie Clinic Amblatory Surgery Center LLC
• Christie Clinic Pathology LLC
• Christie Clinic, PLLC
• Christie Clinic, PLLC
• Christie Clinic, PLLC
• Christie Pharmacy Champaign, LLC
• Jeff Chu, O.D.
• Edward Soojin Chun, D.C.
• Esther Chung, RBT
• Macy Ann Cialkowski, ATC, LAT

• Community/Retail Pharmacy in Champaign, IL
• Providers in Champaign, 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 Apr 29, 2010; 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.