| NPI | 1174610026 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-10-10 |
| Last Updated | 2011-06-08 |
| Authorized Official | Tim Rallo PRESIDENT Phone: 6182436228 |
| Mailing Address | 403 N Hanover, P.o. Box 424 Okawville, IL 62271 United States Phone: (618) 243-6228 | Fax: (628) 243-5608 📍 View Map |
| Primary Practice Address | 403 N Hanover Okawville, IL 62271 United States Phone: (618) 243-6228 | Fax: (618) 243-5608 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | - | 1438680 | NCPDP Provider Identification Number |
| Other (non-Medicare) | IL | 1485374 | NCPDP |
| MEDICAID | IL | 371134674001 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 333600000X – Pharmacy | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | IL | 054011091 |
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About NPI 1174610026
Okawville Pharmacy is an organization registered in the CMS NPPES NPI Registry with NPI number 1174610026. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Okawville, IL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174610026?
NPI 1174610026 belongs to Okawville Pharmacy, a Pharmacy, Community/Retail Pharmacy in Okawville, IL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174610026 active?
The current status of NPI 1174610026 in the NPPES registry is Active. The record was last updated on 2011-06-08.
What specialty is NPI 1174610026?
NPI 1174610026 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174610026?
You can verify NPI 1174610026 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174610026?
The primary practice address on file for NPI 1174610026 is 403 N Hanover, Okawville, IL 62271. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174610026 issued?
NPI 1174610026 was first issued (enumerated) on 2006-10-10. The NPPES record was last updated on 2011-06-08.
Practice Location Map
Okawville Pharmacy is located at 403 N Hanover, Okawville, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Okawville Pharmacy. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174610026. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 054011091 | IL |