John's Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054-013367 Issued in IL

Legal business name

JOHN'S PHARMACY INC

Doing business as

The Sullivan Pharmacy

Practice address

102 E Harrison St
Sullivan, IL 61951-2002

Phone

(217) 728-2331

Fax

(217) 728-2223

NPI assigned

Sep 22, 2006

Last updated

Jul 11, 2014By 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

Mr. Tony Lynn Jones, RPH

Title

President/Owner

Phone

(217) 728-2331

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Sullivan Pharmacy Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• John's Pharmacy Inc

  dba The Sullivan Pharmacy LTC

  • Long Term Care Pharmacy
  • Sullivan, IL
  • NPI 1306508890
  NPPES parent name

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1932208907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E HARRISON ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619512002",
            "telephone_number": "217-728-2331",
            "fax_number": "217-728-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E HARRISON ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619512002",
            "telephone_number": "217-728-2331",
            "fax_number": "217-728-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN'S PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "217-728-2331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054-013367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP (NABP) #",
            "identifier": "1405213",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sullivan Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Hoult
• Alejandra Huerta Hernandez
• Aysha Hutson
• Gabrielle Elyse Jackson
• John's Pharmacy Inc (The Sullivan Pharmacy LTC)
• Anne Kaczkowski, OTR/L
• Brittany Kelley, BA
• Megan Kenny, BA
• Emilee Anne Kruchten
• Edwin Joseph Lacheta Jr., MS

• Community/Retail Pharmacy in Sullivan, IL
• Providers in Sullivan, 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 Jul 11, 2014; 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.