K&S PHARMACIES OF SOUTHERN ILLINOIS LTD (NPI# 1558433243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558433243 |
| Entity Type | Organization |
| Organization Name | K&S PHARMACIES OF SOUTHERN ILLINOIS LTD |
| Other Organization Name | MOODY HEALTH MART PHARMACY |
| Practice Address |
109 E Broadway St Sparta IL 62286-1678 |
| Practice Telephone | 6184432715 |
| Practice Fax Number | 6184436218 |
| Mailing Telephone | 6184432715 |
| Mailing Fax Number | 6184436218 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-10-03 |
| Authorized Official Name | DR. SEAMUS NEAL KLOOS (PHARMACIST IN CHARGE) |
| Authorized Official Telephone | 6184432715 |
| Authorized Official Credential | PHARMD |
| 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 |
054-015396 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1278769 | 05 | |
| PK | 2016628 | 01 |
| Other Name | Type Code |
|---|---|
| Moody Health Mart Pharmacy | Doing Business As Name - Organization |
| MOODY PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649264722 | K&s Pharmacies of Southern Illinois Ltd | Pharmacy | 157 W Broadway St, Sparta, IL 62286-1619 | 2005-09-06 |
| Street Address |
109 E BROADWAY ST |
| City | SPARTA |
| State | IL |
| Zip Code | 62286-1678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467841502 | Rikki Schaefer | Physician Assistant | 205 South Burns Ave, Sparta, IL 62286 | 2015-01-13 |
| 1922242130 | Sparta Community Hospital | Clinic/Center | 211 South Burns Avenue, Sparta, IL 62286 | 2009-05-01 |
| 1245452739 | Human Service Center of Southern Metro East | Clinic/Center | 104 Northtown Drive, Sparta, IL 62286 | 2007-05-03 |
| 1356479497 | Randal W Mcbride | Dentist | 1701 N Market St, Suite 2, Sparta, IL 62286 | 2007-03-01 |
| 1043398050 | Chris M Murry | Chiropractor | 401 West Broadway, Sparta, IL 62286 | 2006-11-01 |
| 1679657548 | Frantz Antoine Charles | Surgery | 818 East Broadway, Sparta Community Hospital, Sparta, IL 62286 | 2006-10-25 |
| 1750497194 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 207 South Burns Ave, Family Health Centre, Sparta, IL 62286 | 2006-08-21 |
| 1740395045 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 1300 North Campus, Sparta Community Hospital, North Campus, Sparta, IL 62286 | 2006-08-20 |
| 1326153552 | Sparta Communty Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 211 South Burns Ave, Quality Healthcare Surgery, Sparta, IL 62286 | 2006-08-20 |
| 1740395003 | Sparta Community Hospital D/b/a Quality Healthcare Clinics | Clinic/Center | 215 South Burns Avenue, Sparta, IL 62286 | 2006-08-20 |
| Find all providers in zip 62286 | ||||
| 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 |
|---|---|---|---|---|
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1841859451 | Ronetco Supermarkets, Inc. | Pharmacy | 18 North Village Boulevard, Sparta, NJ 07871 | 2019-06-07 |
| 1821400797 | Sparta Pharmacy | Pharmacy | 61 Sparta Ave Unit B, Sparta, NJ 07871-1822 | 2014-05-27 |
| 1396845624 | Family Fare, LLC | Pharmacy | 565 S State St, Sparta, MI 49345-1568 | 2006-09-25 |
| 1245872704 | Sparta Drug Center LLC | Pharmacy | 425 N Spring St, Sparta, TN 38583-1323 | 2019-10-16 |
| 1477645075 | New Jersey Cvs Pharmacy LLC | Pharmacy | 11 Theatre Ctr, Sparta, NJ 07871-2405 | 2006-09-29 |
| 1457465437 | Halsey Drug LLC | Pharmacy | 55 S Main St, Sparta, NC 28675-9643 | 2006-08-18 |
| 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 | ||||
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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.