NPIMap

Organization Active NPI

Katherine Shaw Bethea Hospital

Doing business as Katherine Shaw Bethea Hospital Pharmacy

  • Community/Retail Pharmacy
  • Dixon, IL
National Provider Identifier
1497281620
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054.016955 Issued in IL
Legal business name
KATHERINE SHAW BETHEA HOSPITAL
Doing business as
Katherine Shaw Bethea Hospital Pharmacy
Practice address
403 E 1St St
Dixon, IL 61021-3116
Phone
(815) 285-5586
Fax
(815) 285-5923
NPI assigned
May 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Ms. Julie D Mann, FACHE
Title
VP/Chief Administrative Officer
Phone
(815) 285-5538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054.016955 IL Primary

Addresses

Primary practice location

403 E 1St St
Dixon, IL 61021-3116

Mailing address

403 E 1St St
Dixon, IL 61021-3116
Phone (815) 285-5586

Other names 1

  • Katherine Shaw Bethea Hospital Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Katherine Shaw Bethea Hosp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1497281620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5586",
            "fax_number": "815-285-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5586",
            "fax_number": "815-285-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE SHAW BETHEA HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP/CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "815-285-5538",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.016955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katherine Shaw Bethea Hospital Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.