Cains Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.008683 Issued in IL

Legal business name

CAINS DRUG STORE INC

Doing business as

Cains Drug Store

Practice address

1401 N 8TH St
Vandalia, IL 62471-1028

Phone

(618) 283-0196

Fax

(618) 283-9150

NPI assigned

Jul 27, 2006

Last updated

Apr 4, 2016By 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

Darryl TjadenNPI 1467055160

Title

President and Pharmacist

Phone

(618) 283-0196

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• CAINS DRUG STORE Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bond County Pharmacy LLC

  dba Bond County Pharmacy

  • Community/Retail Pharmacy
  • Greenville, IL
  • NPI 1447846902

  O20060206000206

  Same enrollment

Tax ID family

Cains Drug Store Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cains Drug Store Inc

  dba Cain's Drug Store LTC

  • Long Term Care Pharmacy
  • Vandalia, IL
  • NPI 1538084777
  NPD tax ID

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.

• Darryl Paul Tjaden

  • Pharmacist
  • Vandalia, IL
  • NPI 1467055160
  NPD Authorized official

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1568486165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 8TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711028",
            "telephone_number": "618-283-0196",
            "fax_number": "618-283-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 8TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711028",
            "telephone_number": "618-283-0196",
            "fax_number": "618-283-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAINS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "TJADEN",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "PRESIDENT AND PHARMACIST",
        "authorized_official_telephone_number": "618-283-0196"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.008683",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016689",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAINS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karlee Renee Brimberry, LPC
• Brookstone Estates of Vandalia
• Mark Gregory Brunk, D.M.D.
• Robert Butts, MD
• Cains Drug Store Inc (Cain's Drug Store LTC)
• Alivia Cao, DDS
• Mattie Rose Carter
• Carl A Castle, DO
• Kevin Jay Childers, OD
• Jeremy R Clark, D.C.

• Community/Retail Pharmacy in Vandalia, IL
• Providers in Vandalia, 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 Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.