Active NPI
Pavilion Pharmacy LLC
- Community/Retail Pharmacy
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PAVILION PHARMACY LLC
- Practice address
- 301 N 8TH St
Ste 1A106
Springfield, IL 62701-1041 - Phone
- (217) 789-4355
- Fax
- (217) 789-0129
- NPI assigned
- Feb 1, 2006
- 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
- Quin Hostetler
- Title
- Manager
- Phone
- (217) 789-4355
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | IL | Primary |
Addresses
Primary practice location
301 N 8TH St
Ste 1A106
Springfield, IL 62701-1041
Mailing address
301 N 8TH St
Ste 1A106
Springfield, IL 62701-1041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1458442 | Other | OTHER ID NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- Pavilion Pharmacy LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- Springfield, IL
- NPI 1063483451
Locations
301 N 8th St
Ste 1A106
Springfield, IL 62701
Phone (217) 789-4355
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Springfield, IL
- NPI 1639289846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1851362230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 N 8TH ST",
"address_2": "STE 1A106",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N 8TH ST",
"address_2": "STE 1A106",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011041",
"telephone_number": "217-789-4355",
"fax_number": "217-789-0129"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAVILION PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-01",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "HOSTETLER",
"authorized_official_first_name": "QUIN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "217-789-4355"
},
"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": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER",
"identifier": "1458442",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.