Organization Active NPI

Arkins Drug Store Inc

  • Community/Retail Pharmacy
  • La Salle, IL
National Provider Identifier
1619027901
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054013897 Issued in IL
Legal business name
ARKINS DRUG STORE INC
Practice address
1033 8TH St
La Salle, IL 61301-1935
Phone
(815) 223-0460
Fax
(815) 223-0462
NPI assigned
Jan 11, 2007
Last updated
Nov 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Dean Wilmor, RPH
Title
RPH
Phone
(815) 223-0460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054013897 IL Primary

Addresses

Primary practice location

1033 8TH St
La Salle, IL 61301-1935

Mailing address

1033 8TH St
La Salle, IL 61301-1935

Other identifiers 2

IdentifierTypeStateIssuer
1423932OtherOTHER ID NUMBER
3664097450001MedicaidIL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2201658Arkins Drug Store1033 8TH St, La Salle, IL 61301Certificate of waiverNov 22, 2026

National Provider Directory

National Provider Directory

Locations

1033 8th St
La Salle, IL 61301
Phone (815) 223-0460

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1619027901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 8TH ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613011935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 8TH ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613011935",
            "telephone_number": "815-223-0460",
            "fax_number": "815-223-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKINS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "WILMOR",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "815-223-0460",
        "authorized_official_credential": "RPH"
    },
    "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": "054013897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1423932",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3664097450001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Salle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.