Coal City Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054007459 Issued in IL

Legal business name

COAL CITY PHARMACY

Practice address

175 S Broadway St
Coal City, IL 60416-1532

Phone

(815) 634-2391

NPI assigned

May 11, 2007

Last updated

Jul 30, 2008By 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

Thomas E BeverlyNPI 1548301500

Title

Owner

Phone

(815) 634-2391

Specialties & licenses 1

Addresses

Locations

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.

• Thomas E Beverly, R.PH.

  • Pharmacist
  • Coal City, IL
  • NPI 1548301500
  NPD (past) Authorized official

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1497960744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S BROADWAY ST",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604161532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S BROADWAY ST",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604161532",
            "telephone_number": "815-634-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAL CITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "BEVERLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-634-2391"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054007459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caricare Mobile Medical LLC
• Jennifer Wai-Ling Chu, O.D.
• Coal City Cu School Dist 1
• Coal City Dental Center
• Coal City Fire Protection District
• Daniel Jurak D O S C
• Brittany Eikey, LPC
• Encounter Health, PLLC (Encounter Health)
• Existential Counselor Societ LTD.
• Kalli Fuller, LSW

• Community/Retail Pharmacy in Coal City, IL
• Providers in Coal City, 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 Jul 30, 2008; 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.