NPIMap

Organization Active NPI

Carle Bromenn Medical Center

Doing business as The Atrium Pharmacy

  • Community/Retail Pharmacy
  • Normal, IL
National Provider Identifier
1962489815
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054016773 Issued in IL
Legal business name
CARLE BROMENN MEDICAL CENTER
Doing business as
The Atrium Pharmacy
Practice address
1304 Franklin Ave
Normal, IL 61761-3558
Phone
(309) 268-5797
Fax
(309) 268-5524
NPI assigned
Dec 30, 2005
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Aron Klein
Title
Vice President Finance
Phone
(309) 268-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054016773 IL Primary

Addresses

Primary practice location

1304 Franklin Ave
Normal, IL 61761-3558

Mailing address

1304 Franklin Ave
Normal, IL 61761-3558
Phone (309) 268-5797

Other identifiers 1

IdentifierTypeStateIssuer
2123915OtherPK

Other names 1

  • The Atrium Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carle Bromenn Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1962489815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-268-5797",
            "fax_number": "309-268-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-268-5797",
            "fax_number": "309-268-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE BROMENN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "ARON",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "309-268-2410"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2123915",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Atrium Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Atrium Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.