Greenpark Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054013276 Issued in IL

Legal business name

GREENPARK PHARMACY INC

Practice address

500 Green Park Ave
Colona, IL 61241-9620

Phone

(309) 792-1600

Fax

(309) 792-1625

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Karen Garner, RPH

Title

Owner/Pharmacist

Phone

(309) 792-1600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GREEN PARK PHARMACY Doing business as

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1902811540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612410050",
            "telephone_number": "309-792-1600",
            "fax_number": "309-792-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GREEN PARK AVE",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612419620",
            "telephone_number": "309-792-1600",
            "fax_number": "309-792-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENPARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "309-792-1600",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054013276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2022752",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364094320001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREEN PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Colona, IL
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.