WATT BROS PHARMACY INC (NPI# 1053483834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053483834 |
| Entity Type | Organization |
| Organization Name | WATT BROS PHARMACY INC |
| Other Organization Name | WATT BROTHERS PHARMACY |
| Practice Address |
830 N Grand Ave E Springfield IL 62702-3933 |
| Practice Telephone | 2175223331 |
| Practice Fax Number | 2175229029 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN WATT (PRE) |
| Authorized Official Telephone | 2175223331 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| X | 333600000X | Pharmacy | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 364155418001 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1427601 | 01 |
| Other Name | Type Code |
|---|---|
| WATT BROTHERS PHARMACY | Doing Business As Name - Organization |
| Street Address |
830 N GRAND AVE E |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| 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 |
|---|---|---|---|---|
| 1386205524 | Quinate Pharmacy LLC | Pharmacy | 1569 Ga Highway 21 S, Springfield, GA 31329-5214 | 2019-06-27 |
| 1295209443 | St Johns Hospital of The Hospital Sisters of The Third Order of St F | Pharmacy | 400 N 9th St Ste 1500, Springfield, IL 62702-5310 | 2019-01-21 |
| 1770093122 | Genoa Healthcare, LLC | Pharmacy | 417 Liberty St Ste 1b, Springfield, MA 01104-3739 | 2017-10-11 |
| 1316483266 | Springfield Clinic, LLP | Pharmacy | 900 N 1st St Rm 4066, Springfield, IL 62702-3749 | 2017-01-17 |
| 1194277681 | Grove Professional Pharmacy, Inc | Pharmacy | 1636 S Glenstone Ave Ste 108, Springfield, MO 65804-1512 | 2016-10-31 |
| 1962852012 | Main Sail Enterprises South LLC | Pharmacy | 222 E Primrose St Ste B, Springfield, MO 65807-5233 | 2016-06-20 |
| 1588042816 | Main Sail Enterprises-downtown LLC | Pharmacy | 655 S Campbell Ave, Springfield, MO 65806-2901 | 2015-05-06 |
| 1972901189 | Fred's Stores of Tennessee Inc | Pharmacy | 1117 Lincoln Park Rd, Springfield, KY 40069 | 2014-12-22 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1932529716 | Walgreen Co | Pharmacy | 440 E Tampa St Ste 100, Springfield, MO 65806-1131 | 2014-04-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on WATT BROS PHARMACY INC.
| 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.