Feddco Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054018112 Issued in IL

Legal business name

FEDDCO INC

Doing business as

MedPlus Pharmacy

Practice address

111 N State St Ste C
Westville, IL 61883-1461

Phone

(217) 267-8077

Fax

(217) 267-6082

NPI assigned

May 9, 2006

Last updated

Feb 16, 2017By 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

Fidelis Okeke

Title

President

Phone

(217) 403-1371

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MedPlus Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1811946510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N STATE ST STE C",
            "city": "WESTVILLE",
            "state": "IL",
            "postal_code": "618831461",
            "telephone_number": "217-442-1100",
            "fax_number": "217-442-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N STATE ST STE C",
            "city": "WESTVILLE",
            "state": "IL",
            "postal_code": "618831461",
            "telephone_number": "217-267-8077",
            "fax_number": "217-267-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDDCO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "OKEKE",
        "authorized_official_first_name": "FIDELIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-403-1371"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054018112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedPlus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chavon Banks, DC
• Dawn G Campbell, LMT ABMP NCTMB
• Shaun Patrick Cox
• Sherri J Givens, CCC/SLP
• Heidi Michele Hackett, CCC-SLP
• Marsha Lynne Hatchel
• Highland Park CVS, L.L.C. (CVS Pharmacy # 06924)
• Jennifer Jean Jenkins, CMF

• Community/Retail Pharmacy in Westville, IL
• Providers in Westville, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.