PINCKNEYVILLE COMMUNITY HOSPITAL (NPI# 1063473148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063473148 |
| Entity Type | Organization |
| Organization Name | PINCKNEYVILLE COMMUNITY HOSPITAL |
| Other Organization Name | PINCKNEYVILLE COMMUNITY HOSPITAL PHARMACY |
| Practice Address |
5383 State Route 154 Pinckneyville IL 62274-3342 |
| Practice Telephone | 6183572187 |
| Practice Fax Number | 6183578888 |
| Mailing Telephone | 6183572187 |
| Mailing Fax Number | 6183578888 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2016-01-26 |
| Authorized Official Name | KARA JO CARSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6183575902 |
| Authorized Official Credential | MACC, CPA, CHFP |
| Is Organization Subpart | Y |
| Parent Organization Name | PINCKNEYVILLE COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | 141307 | 01 | |
| IL | NABP | 1454127 | 01 |
| Other Name | Type Code |
|---|---|
| Pinckneyville Community Hospital Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689646523 | Pinckneyville Community Hospital | General Acute Care Hospital | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2006-02-05 |
| 1295974327 | Pinckneyville Community Hospital | General Acute Care Hospital | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2009-02-12 |
| 1275796971 | Pinckneyville Community Hospital | General Acute Care Hospital | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1407019102 | Pinckneyville Community Hospital | Hospice Care, Community Based | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1316100019 | Pinckneyville Community Hospital | General Acute Care Hospital | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1124281829 | Pinckneyville Community Hospital | Skilled Nursing Facility | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1033372735 | Pinckneyville Community Hospital | Clinic/Center | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1861655565 | Pinckneyville Community Hospital | Clinic/Center | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1215190913 | Pinckneyville Community Hospital | Home Health | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| 1104089804 | Pinckneyville Community Hospital | Pharmacy | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PINCKNEYVILLE COMMUNITY HOSPITAL | 5383 State Route 154, Pinckneyville, IL 62274-3342 |
| Street Address |
5383 STATE ROUTE 154 |
| City | PINCKNEYVILLE |
| State | IL |
| Zip Code | 62274-3342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689646523 | Pinckneyville Community Hospital | General Acute Care Hospital | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2006-02-05 |
| 1689292997 | Amber Marie Kellerman | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2020-07-13 |
| 1326660440 | Leah M. Hopp | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2020-05-12 |
| 1508386533 | Sabrina Haque I | Family Medicine | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2017-06-21 |
| 1831642164 | Miles Priebe | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2016-08-03 |
| 1427456961 | Alisa D Dearmond | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274 | 2014-12-16 |
| 1619210721 | Andrea Marie Epplin | Nurse Practitioner | 5383 State Route 154, Family Medical Center, Pinckneyville, IL 62274 | 2013-03-27 |
| 1366733800 | Andrew James Forbes | Internal Medicine | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2011-05-02 |
| 1134422652 | Mariah Kathryn Charles | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2010-12-07 |
| 1326155029 | Pinckneyville Community Hospital | Family Medicine | 5383 State Route 154, Pinckneyville, IL 62274-3342 | 2006-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912260233 | Kathy Lynn Heard | Physical Therapy Assistant | 101 N. Walnut St., Pinckneyville, IL 62274 | 2012-06-21 |
| 1235254350 | Timothy Alan Mathis | Emergency Medicine | 202 S Walnut St, Pinckneyville, IL 62274 | 2007-03-20 |
| 1225194988 | Perry County Trans Van | Non-emergency Medical Transport (VAN) | 602 S Douglas St, Pinckneyville, IL 62274 | 2006-12-28 |
| 1063591261 | Medical Arts Sc | Family Medicine | 13 North Walnut Street, Pinckneyville, IL 62274 | 2006-11-06 |
| 1588670426 | Ralph Kane Chapman | Dentist | Box 469, 314 W South St, Pinckneyville, IL 62274 | 2006-07-31 |
| 1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
| 1992840821 | Wayne Ray Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2007-02-20 |
| 1194384669 | Thaddeus Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2019-06-10 |
| 1457855330 | Family Dental Center of Pinckneyville LLC | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2018-03-23 |
| 1346410156 | The Family Dental Center of Pinckneyville | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2008-03-07 |
| Find all providers in zip 62274 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
| 1104089804 | Pinckneyville Community Hospital | Pharmacy | 101 N Walnut St, Pinckneyville, IL 62274-1034 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702549 | Aster Pharmacy LLC | Pharmacy | 9213 Waukegan Rd, Morton Grove, IL 60053-2102 | 2020-05-27 |
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
| 1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
| 1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
| 1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
| 1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
| 1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
| City | PINCKNEYVILLE |
| Zip Code | 62274 |
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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.