MEDICATE PHARMACY INC (NPI# 1871086082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871086082 |
| Entity Type | Organization |
| Organization Name | MEDICATE PHARMACY INC |
| Practice Address |
5869 Bond Ave Centreville IL 62207-2300 |
| Mailing Address |
1833 Kingshighway Washington Park IL 62204 |
| Practice Telephone | 6188572608 |
| Practice Fax Number | 6188572610 |
| Mailing Telephone | 6188743000 |
| Mailing Fax Number | 6188743103 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |
| Authorized Official Name | MICHAEL LEE SCHALTENBRAND (PRESIDENT) |
| Authorized Official Telephone | 6188751000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054-018736 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEA LICENSE NUMBER | FM4843606 | 01 |
| IL | CONTROLLED SUBSTANCE LICENSE NUMBER | CO014205 | 01 |
| IL | ILLINOIS PHARMACY LICENSE NUMBER | 054-018736 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558777938 | Medicate Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2741 W Layton Ave Ste 102, Milwaukee, WI 53221-2600 | 2014-07-07 |
| 1841245404 | Medicate Pharmacy Inc | Pharmacy | 1833 Kingshighway, Washington Park, IL 62204-2135 | 2006-05-23 |
| 1407244502 | Medicate Pharmacy Inc | Pharmacy | 2166 Madison Ave, Granite City, IL 62040-4700 | 2014-12-26 |
| Street Address |
5869 BOND AVE |
| City | CENTREVILLE |
| State | IL |
| Zip Code | 62207-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114493723 | Monica Marie Magowan | Nurse Practitioner | Touchette Regional Hospital, 5900 Bond Ave, Centreville, IL 62207 | 2018-10-22 |
| 1063708345 | Porshia Lenee' Egerson | Student in an Organized Health Care Education/Training Program | 6032 Clarita Ave, Centreville, IL 62207-1019 | 2011-06-24 |
| 1679742506 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 1501 S G St, East Saint Louis, IL 62207-2057 | 2008-02-25 |
| 1780853614 | Comprehensive Mental Health Center of St. Clair County, Inc. | Clinic/Center | 1500 Wilford Ave, East Saint Louis, IL 62207-2066 | 2008-02-25 |
| 1891395893 | Cheryl Lynn Eubanks | Technician | 1710 Mccasland Ave, East Saint Louis, IL 62207-2245 | 2020-10-28 |
| 1255357224 | Mohammad Hashemi | Radiology | 5900 Bond Ave, East Saint Louis, IL 62207-2326 | 2006-07-14 |
| 1952900763 | Danielle Victoria Williams | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-10-22 |
| 1750992459 | Touchette Regional Hospital Inc | Psychiatric Unit | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-08-14 |
| 1932722295 | Alecia E Marks | Social Worker | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-05-21 |
| 1194345322 | Lisa Bicket | Social Worker | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-04-17 |
| Find all providers in zip 62207 | ||||
| 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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| 1669901815 | Bridge Healthcare Pharmacy LLC | Pharmacy | 658 E. Main St, Suite 1, Centreville, MI 49032 | 2017-06-09 |
| 1053865337 | Chungkang Pharmacy, LLC | Pharmacy | 14637 Lee Highway, #109b, Centreville, VA 20121 | 2016-08-04 |
| 1134426372 | One Stop Pharmacy Inc | Pharmacy | 13818-b Braddock Rd, Centreville, VA 20121 | 2011-02-24 |
| 1184886145 | Hairston & Dixon Inc | Pharmacy | 14260c Centreville Sq, Centreville, VA 20121-2364 | 2008-06-30 |
| 1265570428 | J & S Drugs, Inc | Pharmacy | 1130 Walnut St, Centreville, AL 35042-2811 | 2007-02-01 |
| 1508969221 | Alabama Cvs Pharmacy, L.L.C. | Pharmacy | 155 Birmingham Rd Ste 114, Centreville, AL 35042-2949 | 2006-09-07 |
| 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 | ||||
| City | CENTREVILLE |
| Zip Code | 62207 |
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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.