Groceries of Southern Illinois LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

GROCERIES OF SOUTHERN ILLINOIS LLC

Practice address

10 Southgate Ctr
Freeburg, IL 62243-1541

Phone

(618) 207-3186

Fax

(618) 539-3089

NPI assigned

Jun 6, 2019

Organization subpart

No

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

Authorized official

Name

Bryan Victor Schneider, PHARMD

Title

Director of Pharmacy

Phone

(618) 207-3186

Specialties & licenses 1

Addresses

Other names 1

• freeburg pharmacy Doing business as

Tax ID family

Freeburg Pharmacy2 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.

• Groceries of Southern Illinois LLC

  • Community/Retail Pharmacy
  • New Athens, IL
  • NPI 1841620960
  NPD tax ID

Locations

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1770142580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SOUTHGATE CTR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622431541",
            "telephone_number": "618-207-3186",
            "fax_number": "618-539-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOUTHGATE CTR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622431541",
            "telephone_number": "618-207-3186",
            "fax_number": "618-539-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROCERIES OF SOUTHERN ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-06",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "618-207-3186",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "freeburg pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "freeburg pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Freeburg Nursing and Rehab LLC
• Freeburg Vision Center, Inc.
• Samantha Glasco, D.C.
• Elizabeth Jean Gonzalez, LMT
• Groceries of Southern Illinois LLC
• Groceries of Southern Illinois, LLC.
• Jamie L Hahne
• Richard Benjamin Hamm, O.D.
• Burl Wayne Hand III, DDS
• Denise Hand

• All providers in Freeburg, IL
• Long Term Care Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.