Groceries of Southern Illinois LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054009538 Issued in IL

Legal business name

GROCERIES OF SOUTHERN ILLINOIS LLC

Practice address

10 Southgate Ctr
Freeburg, IL 62243-1541

Phone

(618) 539-5577

Fax

(618) 539-3089

NPI assigned

Jul 30, 2006

Organization subpart

No

Name

Bryan Victor Schneider, PHARMD

Title

Director of Pharmacy

Phone

(618) 207-3186

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

• Groceries of Southern Illinois LLC

  • Community/Retail Pharmacy
  • Smithton, IL
  • NPI 1326419912
  NPD tax ID
• Groceries of Southern Illinois, LLC.

  • Community/Retail Pharmacy
  • Red Bud, IL
  • NPI 1912075151
  NPD tax ID

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

• Frances A Schneider

  • Family Nurse Practitioner
  • Iowa City, IA
  • NPI 1467887497
  NPD (past)

Tax ID family

Groceries of Southern Il (3 organizations share this tax ID)

• Freeburg pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 1, 2022.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1528073178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622360140",
            "telephone_number": "618-539-5577",
            "fax_number": "618-539-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOUTHGATE CTR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622431541",
            "telephone_number": "618-539-5577",
            "fax_number": "618-539-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROCERIES OF SOUTHERN ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "618-207-3186",
        "authorized_official_credential": "PHARMD"
    },
    "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": "054009538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2019782",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371239582001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freeburg pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Freeburg Community High School
• Freeburg Nursing and Rehab LLC
• Freeburg Vision Center, Inc.
• Samantha Glasco, D.C.
• Elizabeth Jean Gonzalez, LMT
• Groceries of Southern Illinois LLC
• Groceries of Southern Illinois, LLC.
• Jamie L Hahne
• Richard Benjamin Hamm, O.D.
• Burl Wayne Hand III, DDS

• All providers in Freeburg, IL
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.