PROPHARM RX INC (NPI# 1306102728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306102728 |
| Entity Type | Organization |
| Organization Name | PROPHARM RX INC |
| Other Organization Name | PROPHARM RX INC |
| Practice Address |
115 S Macoupin St Gillespie IL 62033-1516 |
| Mailing Address |
113 S Macoupin St Pob 59 Gillespie IL 62033-1516 |
| Practice Telephone | 2178393233 |
| Practice Fax Number | 2178393233 |
| Mailing Telephone | 2178392909 |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-11 |
| Authorized Official Name | MAURICE SULLIVAN (SEC/TRES) |
| Authorized Official Telephone | 2178392909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1486617 | 01 |
| Other Name | Type Code |
|---|---|
| PROPHARM RX INC | Doing Business As Name - Organization |
| Street Address |
115 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 | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936132 | Aafiyah Solutions Inc | Pharmacy | 1041 W Golf Rd, Hoffman Estates, IL 60169-1339 | 2019-11-11 |
| 1265805592 | Professional Pharmacy Inc | Pharmacy | 2069 Barrington Rd, Hoffman Estates, IL 60169-2086 | 2015-11-09 |
| 1861880833 | Al-machnee Inc | Pharmacy | 7953 S Cicero Ave, Chicago, IL 60652-2037 | 2014-12-29 |
| 1083002034 | Premier Family Pharmacy Inc | Pharmacy | 5600 W 87th St Ste B, Burbank, IL 60459-2902 | 2014-12-29 |
| 1699189134 | Custom Care Pharmacy LLC | Pharmacy | 7007 North Ave, Oak Park, IL 60302-1001 | 2014-06-12 |
| 1588082127 | Bolingbrook Compounding Pharmacy | Pharmacy | 402 W Boughton Rd Ste C, Bolingbrook, IL 60440-1985 | 2014-04-01 |
| 1588906507 | Pill Shop Pharmacy Inc | Pharmacy | 3535 E New York St Ste 117, Aurora, IL 60504-4466 | 2013-03-18 |
| 1285970574 | Northern Rx LLC | Pharmacy | 2012 E. Nw Hwy., Arlington Heights, IL 60004 | 2012-12-14 |
| 1376802462 | Rock Valley Compounding Pharmacy LLC | Pharmacy | 811 S Perryville Rd Unit 109, Rockford, IL 61108-4323 | 2012-05-09 |
| 1598058273 | Care One Pharmacy Services LLC | Pharmacy | 3855 Oakton St, Skokie, IL 60076-3429 | 2011-05-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROPHARM RX INC.
| 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.