K&S Pharmacies of Southern Illinois LTD

Organization Active NPI Community/Retail Pharmacy · Sparta, IL

NPI 1558433243 · NPPES record last updated Oct 3, 2018

Key facts

NPI: 1558433243
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: 054-015396 (IL)
Legal business name: K&S PHARMACIES OF SOUTHERN ILLINOIS LTD
Practice address: 109 E Broadway St
Sparta, IL 62286-1678
Phone: (618) 443-2715
Fax: (618) 443-6218
NPI assigned: Nov 15, 2006
Organization subpart: No

Authorized official

Name: Dr. Seamus Neal Kloos, PHARMD
Title: Pharmacist in Charge
Phone: (618) 443-2715

Practitioners 1

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

Seamus Neal Kloos, PHARM.D. Pharmacist · Sparta, IL · NPI 1174647887

NPD

National Provider Directory

Locations

109 E Broadway St
Sparta, IL 62286
Phone (618) 443-1354

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacy	333600000X
Community/Retail Pharmacy	3336C0003X	054-015396	IL	Yes

Addresses

Primary practice location

109 E Broadway St
Sparta, IL 62286-1678

Mailing address

109 E Broadway St
Sparta, IL 62286-1678
Phone (618) 443-2715

Other identifiers

Identifier	Type	State	Issuer
1278769	Medicaid	LA
2016628	Other		PK

Other names

Moody Health Mart Pharmacy Doing business as

Other providers in Sparta, IL

All providers in Sparta, IL · Community/Retail Pharmacy in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.