MT VERNON COMMUNITY PHARMACY INC


Address: 2339 Broadway St, Mount Vernon, IL 62864-2925
Phone: 6182428776

MT VERNON COMMUNITY PHARMACY INC (NPI# 1417923012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417923012
Entity Type Organization
Organization Name MT VERNON COMMUNITY PHARMACY INC
Other Organization Name THE MEDICINE SHOPPE
Practice Address 2339 Broadway St
Mount Vernon
IL 62864-2925
Practice Telephone 6182428776
Mailing Telephone 6182428776
Enumeration Date 2006-02-24
Last Update Date 2011-11-01
Authorized Official Name ERIC BLACK (OWNER)
Authorized Official Telephone 6182428776
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
054016737 IL Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 1447792 01
BLUE CROSS BLUE SHIELD 4132021 01
HEALTHLINK 334555 01

Other Provider/Organization Names

Other Name Type Code
The Medicine Shoppe Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1811543648 Mt Vernon Community Pharmacy Inc Pharmacy 2339 Broadway St, Mount Vernon, IL 62864-2925 2019-08-16

Office Location

Street Address 2339 BROADWAY ST
City MOUNT VERNON
State IL
Zip Code 62864-2925

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811543648 Mt Vernon Community Pharmacy Inc Pharmacy 2339 Broadway St, Mount Vernon, IL 62864-2925 2019-08-16
1598877961 Eric Lee Black Pharmacist 2339 Broadway St, Mount Vernon, IL 62864-2925 2006-08-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619438892 Melissa Pryer Dietitian, Registered 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 2019-03-28
1487145454 Chiropractic Wellness Center of Mt Vernon, LLC. Chiropractor 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 2018-05-24
1851889208 Kimberly Tate Counselor 4110 North Water Place, Mt. Vernon, IL 62864 2018-05-01
1871907790 University Hematology Oncology Inc Specialist #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 2014-06-18
1457771677 Dynamic Counseling and Consultation Services Social Worker 3600 S Water Tower Pl, Mt Vernon, IL 62864 2014-04-27
1619239431 Judith C Morgan Counselor 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 2012-06-08
1073888624 James Brian Verges Counselor 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 2012-03-15
1720352271 Lucinda M. Holdren Counselor 16338 North Illinois Highway 37, Mount Vernon, IL 62864 2012-03-01
1780978627 Jamie M Orange Physical Therapy Assistant 19958 Fairfield Rd, Mt. Vernon, IL 62864 2011-06-08
1780978791 Wendy Marie Claytor Speech-Language Pathologist 600 E Il Hwy 15, Mount Vernon, IL 62864 2011-06-07
Find all providers in zip 62864

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114545571 Medlife Pharmacy LLC Pharmacy 213 Highway 37 Ste 200&300, Mount Vernon, TX 75457-3106 2020-07-10
1396175345 Allcare PC Pharmacy 115 Spring St, Mount Vernon, GA 30445 2013-11-12
1811040918 Brown & Cole Stores LLC Pharmacy 1515 N 18th St, Mount Vernon, WA 98273-2675 2007-01-19
1649374695 Marco Pharmacy and Optical Inc Pharmacy 4121 S Water Tower Pl, Mount Vernon, IL 62864-6293 2006-09-12
1992808695 Hook Superx LLC Pharmacy 700 E 4th St, Mount Vernon, IN 47620-2011 2006-09-07
1467555235 Highland Park Cvs, L.L.C. Pharmacy 2700 Broadway St, Mount Vernon, IL 62864-2342 2006-09-07
1316970650 Haggen, Inc Pharmacy 2601 E Division St, Mount Vernon, WA 98274-4748 2006-07-09
1619592763 Knox Community Hospital Pharmacy 1330 Coshocton Ave, Mount Vernon, OH 43050-1495 2020-06-15
1639644156 Mabd Enterprises, LLC Pharmacy 115 W Spring St, Mount Vernon, GA 30445-2957 2018-10-11
1952827537 Walgreen Co Pharmacy 47 E Prospect Ave, Mount Vernon, NY 10550-2225 2017-08-16
Find all providers in MOUNT VERNON

Competitor

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City MOUNT VERNON
Zip Code 62864

Improve Information

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Dataset Information

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.

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