MT VERNON COMMUNITY PHARMACY INC (NPI# 1811543648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811543648 |
| Entity Type | Organization |
| Organization Name | MT VERNON COMMUNITY PHARMACY INC |
| Practice Address |
2339 Broadway St Mount Vernon IL 62864-2925 |
| Practice Telephone | 6182428776 |
| Practice Fax Number | 6182449475 |
| Mailing Telephone | 6182428776 |
| Mailing Fax Number | 6182449475 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |
| Authorized Official Name | TRACEY ADAMS (GENERAL MANAGER) |
| Authorized Official Telephone | 6182428776 |
| Is Organization Subpart | Y |
| Parent Organization Name | MT VERNON COMMUNITY PHARMACY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| The Medicine Shoppe | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417923012 | Mt Vernon Community Pharmacy Inc | Pharmacy | 2339 Broadway St, Mount Vernon, IL 62864-2925 | 2006-02-24 |
| Street Address |
2339 BROADWAY ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417923012 | Mt Vernon Community Pharmacy Inc | Pharmacy | 2339 Broadway St, Mount Vernon, IL 62864-2925 | 2006-02-24 |
| 1598877961 | Eric Lee Black | Pharmacist | 2339 Broadway St, Mount Vernon, IL 62864-2925 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1629639281 | Hhc Enterprises Inc | Pharmacy | 1451 Yauger Rd Ste 1h, Mount Vernon, OH 43050-7902 | 2019-06-25 |
| 1821264433 | Landrum Drug Inc | Pharmacy | 1319 S Landrum St Ste E, Mount Vernon, MO 65712-1976 | 2008-05-03 |
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|---|---|---|---|---|
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| 1750841342 | Illini Clinic Pharmacy Inc | Pharmacy | 855 Illini Dr Ste 200, Silvis, IL 61282-2904 | 2019-03-21 |
| 1679039358 | Remedi Seniorcare of Chicago, LLC | Pharmacy | 3600 Lacey Road, Suite 500, Downers Grove, IL 60515 | 2019-02-18 |
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1538672449 | Wear Ltc | Pharmacy | 527 N Madison St Ste B, Carthage, IL 62321-1034 | 2017-11-14 |
| 1124546031 | Symbria Rx Services, LLC. | Pharmacy | 3200 Grant St Rm 41, Evanston, IL 60201-1903 | 2017-08-31 |
| 1699146720 | Pharmblue Illinois LLC | Pharmacy | 2960 Chartres St Ste 100, La Salle, IL 61301-1097 | 2015-10-15 |
| 1194144691 | Lifemed Illinois, LLC | Pharmacy | 881 Il Route 83, Bensenville, IL 60106-1219 | 2014-04-11 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.