SULLIVAN DRUGS INC (NPI# 1134104219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134104219 |
| Entity Type | Organization |
| Organization Name | SULLIVAN DRUGS INC |
| Other Organization Name | SULLIVAN DRUGS |
| Practice Address |
113 S Macoupin St Gillespie IL 62033-1516 |
| Mailing Address |
113 S Macoupin St Pob 59 Gillespie IL 62033-1516 |
| Practice Telephone | 2178392877 |
| Practice Fax Number | 2178393233 |
| Mailing Telephone | 2178392877 |
| Mailing Fax Number | 2178393233 |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2014-11-10 |
| Authorized Official Name | MAURICE SULLIVAN (PRES) |
| Authorized Official Telephone | 2178392909 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054002139 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023083 | 01 |
| Other Name | Type Code |
|---|---|
| SULLIVAN DRUGS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205900677 | Sullivan Drugs Inc | Pharmacy | 9563 Lavonia Rd, Carnesville, GA 30521-3254 | 2006-11-20 |
| 1871578583 | Sullivan Drugs Inc | Durable Medical Equipment & Medical Supplies | 103 W Main St, Mount Olive, IL 62069 | 2005-12-14 |
| Street Address |
113 S MACOUPIN ST |
| City | GILLESPIE |
| State | IL |
| Zip Code | 62033-1516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596950 | Laura Michelle Halpin | Physical Therapist | 607 Litchfield Road, Gillespie, IL 62033 | 2019-03-12 |
| 1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
| 1932519618 | Terry Allan | Pharmacist | 113 South Macoupin Street, Gillespie, IL 62033 | 2014-05-02 |
| 1649414558 | Bernadette Kathlene Sobczak | Nurse Practitioner | 807 Broadway, Gillespie, IL 62033 | 2009-04-22 |
| 1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
| 1215044920 | James Paul Verton | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1427575612 | Beth Lynn Sies | Speech-Language Pathologist | 340 Kelly St, Gillespie, IL 62033 | 2017-08-28 |
| 1356599971 | Julia Terese Ruckman | Social Worker | 109 E Maple St, Gillespie, IL 62033 | 2008-09-08 |
| 1124135835 | Bruce W Hughes | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| Find all providers in zip 62033 | ||||
| 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] |
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| Find all providers with the same taxonomy | ||||
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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.