NPIMap

Organization Active NPI

Groceries of Southern Illinois LLC

Doing business as Freeburg pharmacy

  • Community/Retail Pharmacy
  • Freeburg, IL
National Provider Identifier
1528073178
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054009538 Issued in IL
Legal business name
GROCERIES OF SOUTHERN ILLINOIS LLC
Doing business as
Freeburg pharmacy
Practice address
10 Southgate Ctr
Freeburg, IL 62243-1541
Phone
(618) 539-5577
Fax
(618) 539-3089
NPI assigned
Jul 30, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Bryan Victor Schneider, PHARMD
Title
Director of Pharmacy
Phone
(618) 207-3186

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054009538 IL Primary

Addresses

Primary practice location

10 Southgate Ctr
Freeburg, IL 62243-1541

Mailing address

PO Box 140
Columbia, IL 62236-0140
Phone (618) 539-5577

Other names 1

  • Freeburg pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Groceries of Southern Illinois LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freeburg pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeburg, IL

Sources for this page

  • 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.