Groceries of Southern Illinois, LLC.
Organization Active NPI Community/Retail Pharmacy · Red Bud, IL
NPI 1912075151 · NPPES record last updated Aug 4, 2025
Key facts
- NPI
- 1912075151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 054018566 (IL)
- Legal business name
- GROCERIES OF SOUTHERN ILLINOIS, LLC.
- Practice address
- 1375 S Main St
Red Bud, IL 62278-1352 - Phone
- (618) 282-6658
- Fax
- (618) 282-6488
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Meghan Heuring, PHARM.D.
- Title
- Director of Pharmacy
- Phone
- (618) 539-3164
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 2
Practitioners 6
-
Brian Blevins, PHARMD
-
Peggy Ann Rehmer, RPH
-
Bryan Victor Schneider, PHARM D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250725001267 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 8628451572 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Freeburg, IL; Red Bud, IL; Smithton, IL |
National Provider Directory
- Tax ID family
- Groceries of Southern Il
Locations
1375 S Main St
Red Bud, IL 62278
Phone (618) 282-2870
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 054018566 | IL | Yes |
Addresses
Primary practice location
1375 S Main St
Red Bud, IL 62278-1352
Mailing address
1375 S Main St
Red Bud, IL 62278-1352
Phone (618) 282-6658
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 371074357001 | Medicaid | IL | |
| 2023324 | Other | PK |
Other names
- Red Bud Country Mart Pharmacy
Other providers in Red Bud, IL
- Focus Rehabilitation
- Shirley Marie Forcum
- Samantha Garza
- Gibson'S Discount Drugs, Inc
- Viki Goodnick
- Emily Grossmann
- Growing Mindful DBT and Wellness
- Rajendra Gupta
- Isabelle Hamilton
- Amber L Harriman
All providers in Red Bud, IL · Community/Retail Pharmacy in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.