NPIMap

Organization Active NPI

Warren G Murray Developmental Ctr

  • Long Term Care Pharmacy
  • Centralia, IL
National Provider Identifier
1679626550
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
054017317 Issued in IL
Legal business name
WARREN G MURRAY DEVELOPMENTAL CTR
Practice address
1535 W McCord St
Centralia, IL 62801-5805
Phone
(618) 532-1911
Fax
(618) 532-7464
NPI assigned
Jan 22, 2007
Last updated
Dec 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Tara Timmons, PHARM D
Title
Pharmacy MGR
Phone
(618) 532-1811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 054017317 IL Primary
Long Term Care Hospital 282E00000X 059005407 IL

Addresses

Primary practice location

1535 W McCord St
Centralia, IL 62801-5805

Mailing address

1535 W McCord St
Centralia, IL 62801-5805

National Provider Directory

National Provider Directory
Tax ID family
Elisabeth Ludeman Center292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1679626550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 W MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628015805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 W MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628015805",
            "telephone_number": "618-532-1911",
            "fax_number": "618-532-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN G MURRAY DEVELOPMENTAL CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PHARMACY MGR",
        "authorized_official_telephone_number": "618-532-1811",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054017317",
            "primary": true
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "IL",
            "license": "059005407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.