NPIMap

Organization Active NPI

RX Stores LLC

  • Community/Retail Pharmacy
  • Shelbyville, IL
National Provider Identifier
1992792345
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RX STORES LLC
Practice address
1603 W Main St
Shelbyville, IL 62565-9571
Phone
(217) 774-7838
Fax
(217) 774-2058
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
David Falk
Title
Owner
Phone
(217) 362-6226

Specialties & licenses 1

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

Addresses

Primary practice location

1603 W Main St
Shelbyville, IL 62565-9571

Mailing address

2245 W Mound Rd
Decatur, IL 62526-9367
Phone (217) 774-7838

Other identifiers 1

IdentifierTypeStateIssuer
2163725OtherPK

Other names 1

  • Family Drug Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170605001882 IL DME Supplier - Pharmacy 7416224985 Practice locations: Shelbyville, IL
O20171219000292 IL Part B Supplier - Mass Immunization (Roster Biller Only) 7416224985 Practice locations: Shelbyville, IL

National Provider Directory

National Provider Directory
Tax ID family
RX Stores LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1992792345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 W MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269367",
            "telephone_number": "217-774-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 W MAIN ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625659571",
            "telephone_number": "217-774-7838",
            "fax_number": "217-774-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX STORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-362-6226"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Drug Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Drug Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.