NPIMap

Organization Active NPI

Senior Care Pharmacy Services LLC

  • Long Term Care Pharmacy
  • Monticello, IL
National Provider Identifier
1811933013
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
054.016956 Issued in IL
Legal business name
SENIOR CARE PHARMACY SERVICES LLC
Practice address
1212 Bear LN
Monticello, IL 61856-9581
Phone
(217) 762-3950
Fax
(207) 762-7039
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Lisa Marie Bitner
Title
Billing Office Supervisor
Phone
(217) 762-3950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 054.016956 IL Primary

Addresses

Primary practice location

1212 Bear LN
Monticello, IL 61856-9581

Mailing address

1212 Bear LN
Monticello, IL 61856-9581
Phone (217) 762-3950

Other identifiers 4

IdentifierTypeStateIssuer
2021606OtherPK
200498260AMedicaidIA
232963282004MedicaidIL
606162303MedicaidMO

Other names 2

  • MIDWEST SENIOR MINISTRIE SOLE MBR Other name
  • SENIOR CARE PHARMACY LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Bridgeway Christian Village3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1212 Bear Ln
Monticello, IL 61856
Phone (217) 762-3950

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1811933013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 BEAR LN",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618569581",
            "telephone_number": "217-762-3950",
            "fax_number": "207-762-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BEAR LN",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618569581",
            "telephone_number": "217-762-3950",
            "fax_number": "207-762-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "BITNER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "217-762-3950"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054.016956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2021606",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200498260A",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232963282004",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606162303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDWEST SENIOR MINISTRIE SOLE MBR",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SENIOR CARE PHARMACY LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monticello, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.