Critical Care RX, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

54-020902 Issued in IL

Legal business name

CRITICAL CARE RX, LLC

Practice address

126 Oak St
Peoria, IL 61602

Phone

(833) 352-0966

NPI assigned

Jul 3, 2018

Last updated

Nov 22, 2021By 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

Sam Enloe

Title

Member

Phone

(618) 339-4211

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Critical Care RX LLC2 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.

• Critical Care RX, LLC

  • Long Term Care Pharmacy
  • Lisle, IL
  • NPI 1053177576
  NPD tax ID

Locations

Practitioners 5

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.

• Cassidy Louise Domagalla

  • Geriatric Pharmacist
  • Peoria, IL
  • NPI 1386222685
  NPD (past)
• Angie Horlander, PHARMD

  • Pharmacist
  • Peoria, IL
  • NPI 1447831821
  NPD (past)
• Shirley Potts

  • Licensed Practical Nurse
  • Peoria, IL
  • NPI 1558935437
  NPD (past)
• Kimberly Seaman, RN

  • Registered Nurse
  • Peoria, IL
  • NPI 1811579014
  NPD (past)
• Amy Rebecca Snowden, PHARMD

  • Pharmacist
  • Peoria, IL
  • NPI 1053993287
  NPD (past)

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1720574676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1884 LACKLAND HILL PKWY STE 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 OAK ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61602",
            "telephone_number": "833-352-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRITICAL CARE RX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "ENLOE",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "618-339-4211"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "54-020902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "54-020902",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "054.020902",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharecia Crawford
• Katie T. Crawley, D.O.
• Sean Gregory Creeden, M.D.
• Savanna Crider
• Ma. Paz Salamat Cristobal, M.D.
• Dennis J Crnkovich, M.D.
• Joseph P Croegaert, MSW, LCSW
• Joshua A Croland, M.D.
• Trina Croland
• Jennifer L Crone, PT

• Long Term Care Pharmacy in Peoria, IL
• Providers in Peoria, IL by specialty
• Long Term Care Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.