NPIMap

Organization Active NPI

St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • Community/Retail Pharmacy
  • O Fallon, IL
National Provider Identifier
1669969531
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054.020399 Issued in IL
Legal business name
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Practice address
3 Saint Elizabeth Blvd Ste 1300
O Fallon, IL 62269-1281
Phone
(618) 607-5111
Fax
(217) 610-8438
NPI assigned
Apr 17, 2018
Organization subpart
Yes
Parent organization
ST ELIZABETHS HOSPITAL SISTER OF THE THIRD ORDER OF ST FRANCISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mark D Evard
Title
VP of Revenue Cycle
Phone
(217) 492-9651

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054.020399 IL Primary
Specialty Pharmacy 3336S0011X 054.020399 IL

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 1300
O Fallon, IL 62269-1281

Mailing address

3051 Hollis Dr
Springfield, IL 62704-7450
Phone (618) 607-5111

Other names 1

  • HSHS ST. ELIZABETH'S COMMUNITY PHARMACY Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hshs_st_elizabeth_ofallon2202617@ewd.direct.hshs.org Direct

National Provider Directory

National Provider Directory
Tax ID family
St Eliz Hosp8 organizations share this tax ID, including this one
Part of
St Eliz Hosp

Other organizations with this tax ID 7

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

Locations

3 Saint Elizabeth Blvd
Ste 1300
O Fallon, IL 62269
Phone (618) 607-5111

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1669969531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "618-607-5111",
            "fax_number": "217-610-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 1300",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691281",
            "telephone_number": "618-607-5111",
            "fax_number": "217-610-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST ELIZABETHS HOSPITAL SISTER OF THE THIRD ORDER OF ST FRANCIS",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "EVARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.020399",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "IL",
            "license": "054.020399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hshs_st_elizabeth_ofallon2202617@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1 Saint Elizabeth Blvd",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HSHS ST. ELIZABETH'S COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HSHS ST. ELIZABETH'S COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.