Active NPI
G M Andes LTD
Doing business as Andes Health Mart
- Community/Retail Pharmacy
- Effingham, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 054014035
- Legal business name
- G M ANDES LTD
- Doing business as
- Andes Health Mart
- Practice address
- 805 W Fayette Ave
Effingham, IL 62401-2415 - Phone
- (217) 342-9393
- Fax
- (217) 342-9409
- NPI assigned
- May 11, 2006
- Last updated
- Jan 31, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Garrett Andes
- Title
- Owner
- Phone
- (217) 342-9393
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 054014035 | IL | Primary |
Addresses
Primary practice location
805 W Fayette Ave
Effingham, IL 62401-2415
Mailing address
805 W Fayette Ave
Effingham, IL 62401-2415
Phone (217) 342-9393
Other names 1
- ANDES HEALTH MART
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930096842 | IL | DME Supplier - Pharmacy | 2860609476 | Practice locations: Effingham, IL |
| O20110409000070 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2860609476 | Practice locations: Effingham, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2319985 | Andes Health Mart | Certificate of waiver | Mar 10, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- G M Andes LTD
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
805 W Fayette Ave
Effingham, IL 62401
Phone (217) 342-9393
Practitioners & affiliated clinicians
Practitioners 11
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.
-
- Pharmacist
- Effingham, IL
- NPI 1831780295
-
- Pharmacist
- Effingham, IL
- NPI 1780193425
-
- General Practice Registered Nurse
- Effingham, IL
- NPI 1336727502
-
- Pharmacist
- Effingham, IL
- NPI 1730782095
-
- Pharmacist
- Effingham, IL
- NPI 1780803718
-
- Pharmacist
- Effingham, IL
- NPI 1942803184
-
- Pharmacist
- Effingham, IL
- NPI 1073116059
-
- Pharmacist
- Effingham, IL
- NPI 1689113748
-
- Pharmacist
- Effingham, IL
- NPI 1851995369
-
- Pharmacist
- Effingham, IL
- NPI 1023174505
-
- Pharmacist
- Effingham, IL
- NPI 1780459347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643587200000",
"number": "1740230481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 W FAYETTE AVE",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624012415",
"telephone_number": "217-342-9393",
"fax_number": "217-342-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 W FAYETTE AVE",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624012415",
"telephone_number": "217-342-9393",
"fax_number": "217-342-9409"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "G M ANDES LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-11",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A",
"authorized_official_last_name": "ANDES",
"authorized_official_first_name": "GARRETT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "217-342-9393"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IL",
"license": "054014035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ANDES HEALTH MART",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Effingham, IL
- Kelsey Mae Frost, APN
- Fruitful Play Developmental Therapy Service LLC
- Kari Fulk, RN, BSN
- Cinthia Funes
- Michael Colin Funk, CRNA
- G M Andes LTD (Andes Long Term Care)
- Marina Gabriel
- Gahcr II Effingham Alf TRS Sub, LLC (The Glenwood of Effingham)
- Meredith Rachelle Gardner, M.S. CCC-SLP
- James Richard Gartner, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.