PHARMBLUE ILLINOIS LLC (NPI# 1699146720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699146720 |
| Entity Type | Organization |
| Organization Name | PHARMBLUE ILLINOIS LLC |
| Other Organization Name | PHARMBLUE ILLINOIS LLC |
| Practice Address |
2960 Chartres St Ste 100 La Salle IL 61301-1097 |
| Mailing Address |
Po Box 776309 Chicago IL 60677-6309 |
| Practice Telephone | 7247794720 |
| Practice Fax Number | 8448738758 |
| Mailing Telephone | 7247794720 |
| Mailing Fax Number | 7247794721 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2017-03-24 |
| Authorized Official Name | MIKE NELSON (CEO) |
| Authorized Official Telephone | 7247794720 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | 265190 | MN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054-019566 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 454805748001 | 05 | |
| PK | 2154972 | 01 |
| Other Name | Type Code |
|---|---|
| PharmBlue Illinois LLC | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PHARMBLUE ILLINOIS LLC | 99 Washington Avenue, Suite 1008, Albany, New York 12260 |
| Street Address |
2960 CHARTRES ST STE 100 |
| City | LA SALLE |
| State | IL |
| Zip Code | 61301-1097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598912453 | Matthew V Hartman | Dentist | 941 First St, La Salle, IL 61301 | 2008-08-22 |
| 1164501078 | Pamela F Wolf | Counselor | 146 Gooding Street, La Salle, IL 61301 | 2006-11-02 |
| 1265514343 | Rose Mary Schaumberg | Nurse Practitioner | 2970 Chartres Street, Lasalle, IL 61301 | 2006-10-19 |
| 1578668141 | Cynthia L. Ashley | Psychologist | 206 Marquette Street, Suite 203, Lasalle, IL 61301 | 2006-09-14 |
| 1922016849 | Mary Therese Petrella | Nurse Practitioner | 2970 Chartres, Hygienic Institute Community Health Clinic, La Salle, IL 61301 | 2006-08-04 |
| 1073527461 | William L Judge | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2006-07-28 |
| 1124044318 | North Central Behavioral Health Systems, Inc | Clinic/Center | 2960 Chartres St., Lasalle, IL 61301 | 2006-07-14 |
| 1962445247 | William Michael White | Dentist | 225 Gooding St, Suite 1, La Salle, IL 61301 | 2006-06-14 |
| 1730629429 | Liberty Kathleen Grzybowski | Social Worker | 2960 Chartres St., La Salle, IL 61301 | 2017-03-01 |
| 1619267135 | Gergovich Family Chiropractic, LLC. | Chiropractor | 130 3rd St, La Salle, IL 61301 | 2011-04-18 |
| Find all providers in zip 61301 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
Please comment or provide details below to improve the information on PHARMBLUE ILLINOIS LLC.
| 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.