ROANOKE RX LLC (NPI# 1104302249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104302249 |
| Entity Type | Organization |
| Organization Name | ROANOKE RX LLC |
| Other Organization Name | AXLINE PHARMACY 03 |
| Practice Address |
322 N Main St Roanoke IL 61561-7515 |
| Mailing Address |
Po Box 1087 Bloomington IL 61702-1087 |
| Practice Telephone | 3099237711 |
| Practice Fax Number | 3099237714 |
| Mailing Telephone | 3098286767 |
| Mailing Fax Number | 3098286970 |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | TROY WILLIAMS (RPH/OWNER) |
| Authorized Official Telephone | 3096605939 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | ROANOKE RX LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 054020855 | IL | Suppliers |
| Other Name | Type Code |
|---|---|
| Axline Pharmacy 03 | Doing Business As Name - Organization |
| Street Address |
322 N MAIN ST |
| City | ROANOKE |
| State | IL |
| Zip Code | 61561-7515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295838522 | Steven Lee Crawford | Pharmacist | 322 N Main St, Roanoke, IL 61561-0617 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619057031 | Malinda Cooling | Nurse Practitioner | 401 N Main, Roanoke, IL 61561 | 2006-10-17 |
| 1356543854 | Roanoke Benson Cus Dist 60 | Local Education Agency (LEA) | 202 W High Street, Roanoke, IL 61561-0320 | 2007-06-05 |
| 1427121961 | Michael D. Meier | Dentist | 107 W. Ann St., Roanoke, IL 61561-0440 | 2006-11-15 |
| 1649781675 | Jodi Renee Meyer | Speech-Language Pathologist | 202 W High St, Roanoke, IL 61561-7509 | 2017-10-17 |
| 1508887860 | Brad A. Stoecker | Family Medicine | 401 N Main St, Roanoke, IL 61561-7516 | 2006-07-22 |
| 1205918794 | Apostolic Christian Home of Roanoke Illinois Inc. | Skilled Nursing Facility | 1102 W Randolph St, Roanoke, IL 61561-7528 | 2006-10-20 |
| 1770030074 | Apostolic Christian Home of Roanoke Illinois Inc. | Durable Medical Equipment & Medical Supplies | 1102 W Randolph St, Roanoke, IL 61561-7528 | 2016-09-02 |
| 1891756664 | Matthew S Stringer | Chiropractor | 108 W Husseman St, Roanoke, IL 61561-7565 | 2006-03-31 |
| 1053764365 | Michelle M Stephens | Nurse Practitioner | 401 N Main St, Roanoke, IL 61561-7585 | 2016-07-21 |
| 1508988288 | County of Woodford Village of Roanoke | Ambulance | 101 N Main St, Roanoke, IL 61561-7598 | 2007-04-04 |
| Find all providers in zip 61561 | ||||
| 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 |
|---|---|---|---|---|
| 1619253846 | Chs Inc | Pharmacy | 3 Riverside Circle Ground Floor, Roanoke, VA 24016 | 2011-11-02 |
| 1134260516 | Shawsville Pharmacy Inc | Pharmacy | 2201 Crystal Spring Ave Sw, Roanoke, VA 24014-2416 | 2007-02-09 |
| 1992802730 | Sanco Drug Inc | Pharmacy | 1270 Riverland Rd Se, Roanoke, VA 24014-3508 | 2006-09-20 |
| 1497867303 | Bear Creek Drug Inc | Pharmacy | 3328 Brambleton Ave, Roanoke, VA 24018-6523 | 2006-08-31 |
| 1124130034 | Mountain Rx LLC | Pharmacy | 3324 Williamson Rd Nw, Roanoke, VA 24012-4058 | 2006-08-31 |
| 1194730705 | Lineville Clinic Pharmacy LLC | Pharmacy | 3705 Highway 431 Ste B, Roanoke, AL 36274-1430 | 2006-07-30 |
| 1447275169 | Kroger Limited Partnership I | Pharmacy | 4488 Electric Rd, Roanoke, VA 24018-0722 | 2006-07-13 |
| 1356375125 | Kroger Limited Partnership I | Pharmacy | 5050 Rutgers St Nw, Roanoke, VA 24012-1326 | 2006-07-10 |
| 1063446847 | Kroger Limited Partnership I | Pharmacy | 614 Brandon Ave Sw, Roanoke, VA 24015-3212 | 2006-07-10 |
| 1972537751 | Kroger Limited Partnership I | Pharmacy | 7223 Williamson Rd, Roanoke, VA 24019-4234 | 2006-07-10 |
| Find all providers in ROANOKE | ||||
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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.