Pharmax Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

051030067 Issued in IL

Legal business name

PHARMAX INC.

Doing business as

dba Pharmax Pharmacy #0912

Practice address

1221 Charleston Ave
Mattoon, IL 61938-4130

Phone

(217) 234-8881

Fax

(217) 234-8885

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Larry T McIntosh

Title

President

Phone

(314) 954-5510

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba Pharmax Pharmacy #0912 Doing business as

Practitioners 1

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

• David R Clausing, RPH

  • Pharmacist
  • Mattoon, IL
  • NPI 1750395919
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1487766341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 CHARLESTON AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384130",
            "telephone_number": "217-234-8881",
            "fax_number": "217-234-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 CHARLESTON AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384130",
            "telephone_number": "217-234-8881",
            "fax_number": "217-234-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMAX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-954-5510",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "051030067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "1455927",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Pharmax Pharmacy #0912",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dwight Pentzien, D.O.
• Kimberly Penza, SLPA
• Dominic Perrino, D.O.
• Petersen Health Care II, Inc
• Petersen Management Company, LLC
• Philco Dental Group LLC - Mattoon
• Philip B. Kepp, DDS,PC
• Kali Pierce, BA
• Ryan Robert Pine, M.D.
• George Issac Plamoottil, M.D.

• Community/Retail Pharmacy in Mattoon, IL
• Providers in Mattoon, 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 Mar 7, 2023; 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.