NPIMap

Organization Active NPI

Pavilion Foundation Pharmacy

  • Psychiatric Hospital
  • Champaign, IL
National Provider Identifier
1780055608
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
054016976 Issued in IL
Legal business name
PAVILION FOUNDATION PHARMACY
Practice address
809 W Church St
Champaign, IL 61820-3320
Phone
(217) 373-1860
Fax
(217) 373-1877
NPI assigned
Oct 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Joe Sheehy
Title
Ceo
Phone
(217) 373-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 054016976 IL Primary

Addresses

Primary practice location

809 W Church St
Champaign, IL 61820-3320

Mailing address

809 W Church St
Champaign, IL 61820-3320
Phone (217) 373-1860

National Provider Directory

National Provider Directory
Tax ID family
Pavilion Foundation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1780055608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W CHURCH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203320",
            "telephone_number": "217-373-1860",
            "fax_number": "217-373-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W CHURCH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203320",
            "telephone_number": "217-373-1860",
            "fax_number": "217-373-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION FOUNDATION PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "SHEEHY",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-373-1700"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IL",
            "license": "054016976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.