POTTER PHARMACY INC (NPI# 1073594859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073594859 |
| Entity Type | Organization |
| Organization Name | POTTER PHARMACY INC |
| Other Organization Name | POTTER DRUG INC |
| Practice Address |
200 S 6th St Petersburg IL 62675-1553 |
| Mailing Address |
Po Box 498 Petersburg IL 62675-0498 |
| Practice Telephone | 2176322287 |
| Practice Fax Number | 2176322033 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2014-03-06 |
| Authorized Official Name | PATRICK POTTER (PRESIDENT) |
| Authorized Official Telephone | 2176322288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054006072 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023312 | 01 |
| Other Name | Type Code |
|---|---|
| POTTER DRUG INC | Doing Business As Name - Organization |
| Street Address |
200 S 6TH ST |
| City | PETERSBURG |
| State | IL |
| Zip Code | 62675-1553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669970984 | Timothy Arthur Gleason | Pharmacist | 200 S 6th St, Petersburg, IL 62675-6267 | 2018-02-01 |
| 1598145724 | Gleason Pharmacy Services Inc | Pharmacy | 200 S 6th St, Petersburg, IL 62675-1553 | 2015-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962519405 | Porta Comm. Unit District 202 | Local Education Agency (LEA) | 17651 Bluejay Road, Petersburg, IL 62675 | 2006-08-23 |
| 1295704021 | Menard County Health Department | Home Health | 1120 N 4th, Suite A, Petersburg, IL 62675 | 2006-03-15 |
| 1720035611 | Menard Convalescent Center, Inc | Skilled Nursing Facility | 120 W Antle St, Petersburg, IL 62675-1035 | 2006-05-27 |
| 1003068776 | Menard Convalescent Center, Inc | Skilled Nursing Facility | 120 W Antle St, Petersburg, IL 62675-1035 | 2008-10-14 |
| 1528106812 | County of Menard | Public Health or Welfare | 1120 N 4th St, Suite A, Petersburg, IL 62675-1115 | 2007-02-01 |
| 1922478916 | Ashleigh Renee Smith | Private Vehicle | 703 N 7th St, Petersburg, IL 62675-1144 | 2015-10-02 |
| 1952872269 | Abbey Lynn Venturini | Social Worker | 323 W Rutledge St, Petersburg, IL 62675-1239 | 2018-12-12 |
| 1285936872 | Donald P. Hartman | Dentist | 213 N 5th, Petersburg, IL 62675-1303 | 2010-12-02 |
| 1114197514 | Paul Douglas Davis | Dentist | 213 N 5th St, Petersburg, IL 62675-1303 | 2008-03-03 |
| 1619091238 | Donald Paul Hartman | Dentist | 213 N 5th St, Petersburg, IL 62675-1303 | 2007-03-19 |
| Find all providers in zip 62675 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891885364 | Porter Drug | Pharmacy | 1522 Main, Petersburg, TX 79250 | 2006-10-13 |
| 1760586432 | Virginia Cvs Pharmacy LLC | Pharmacy | 2100 South Crater Rd, Petersburg, VA 23805-9277 | 2006-09-12 |
| 1477568434 | Walgreen Co | Pharmacy | 3298 S Crater Rd, Petersburg, VA 23805-9217 | 2006-07-29 |
| 1598224743 | E. A. Hawse Health Center, Inc. | Pharmacy | 111 S Grove St, Petersburg, WV 26847-1804 | 2019-03-18 |
| 1598145724 | Gleason Pharmacy Services Inc | Pharmacy | 200 S 6th St, Petersburg, IL 62675-1553 | 2015-06-03 |
| 1538259403 | Petersburg Pharmacy, Inc | Pharmacy | 1 Centre Dr, Suite 100, Petersburg, IL 62675-9467 | 2006-10-13 |
| 1497858104 | Hook Superx LLC | Pharmacy | 200 W Main St, Petersburg, IN 47567-8525 | 2006-09-07 |
| 1083613178 | Clay Pharmaceuticals Inc | Pharmacy | 518 S Sycamore St, Petersburg, VA 23803-5038 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 62675 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.