HINES VA CMOP (NPI# 1700834116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700834116 |
| Entity Type | Organization |
| Organization Name | HINES VA CMOP |
| Practice Address |
5000 S 5th Ave Bldg. 37 Hines IL 60141-3030 |
| Practice Telephone | 7087867821 |
| Practice Fax Number | 7087867980 |
| Mailing Telephone | 7087867820 |
| Mailing Fax Number | 7087867980 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-12-02 |
| Authorized Official Name | KENNETH SIEHR (DEPUTY CHIEF CONSULTANT PBM/CMOP) |
| Authorized Official Telephone | 9137584750 |
| Authorized Official Credential | R.PH., MPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NCPDP# | 1478367 | 01 |
| IL | DEA# | BH4654617 | 01 |
| Street Address |
5000 S 5TH AVE BLDG. 37 |
| City | HINES |
| State | IL |
| Zip Code | 60141-3030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508865452 | Patricia M Knisley | Dietitian, Registered | 5000 S 5th Ave, Food and Nutrition Services (120d), Hines, IL 60141-3030 | 2005-07-21 |
| 1821699273 | Matthew Nakeem Williams | Registered Nurse | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-11-03 |
| 1225638877 | Christine Marie Desparrois | Technician/Technologist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-31 |
| 1558961565 | Maggie Elizabeth Murphy | Music Therapist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-28 |
| 1689273781 | Carrie Gatz | Music Therapist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-20 |
| 1124626304 | Anne Kathryn Thorndyke | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-11 |
| 1033726781 | Josmi Joseph | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-28 |
| 1558975003 | Phillip M Christenson | Social Worker | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-02 |
| 1730793266 | Tanya Elaine Pringle | Social Worker | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-02 |
| 1912518796 | Dana Viola Shepherd | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992273056 | Donizetti Razo | Social Worker | 5000 S. Fifth Avenue, Building 228, Room 4078, Hines, IL 60141 | 2018-11-07 |
| 1558838086 | Michael Calia | Social Worker | Patient Advocate Office #122, Edward Hines Jr. Va Hospital, 5000 S. 5th Avenue, Hines, IL 60141 | 2018-11-02 |
| 1639684640 | David Alan Edwards | Specialist/Technologist | 5000 S 5ht Ave, Building 113, Hines, IL 60141 | 2017-12-13 |
| 1689189706 | Joseph Jorgenson | Rehabilitation Practitioner | Hines Brc Bld 113, 5000 S 5th Ave, 124, Hines, IL 60141 | 2017-12-12 |
| 1154836823 | Kristy Bassett | Social Worker | 5000 S 5th Ave Bldg 2284n, Hines, IL 60141 | 2017-12-04 |
| 1396269387 | Aaron Jerome Brown | Kinesiotherapist | 5000 S 5th. Ave., Hines, IL 60141 | 2017-08-01 |
| 1932454634 | Michael Ladra Marquez | Physical Therapist | 5000 South 5th Ave., Edward Hines Jr. Va Hospital, Hines, IL 60141 | 2012-07-18 |
| 1437489713 | Linda Christime Bronski | Social Worker | Fifth Ave and Roosevelt Ave Bldg 228, Edward Hines Jr Va Hospital, Hines, IL 60141 | 2010-01-08 |
| 1700113859 | Sarah Jean Ostrowski | Recreation Therapist | 2100 S 5th Ave, Hines, IL 60141 | 2009-11-11 |
| 1841447299 | Narayanarao Madamala | Pharmacist | Hines Consolidated Mail Out Pharmacy, Building 37nw, Hines, IL 60141 | 2008-08-27 |
| Find all providers in zip 60141 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396793378 | Hines Vamc | Department of Veterans Affairs (VA) Pharmacy | 5000 S 5th Ave, Hines, IL 60141-3030 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033177589 | Madison Vamc | Department of Veterans Affairs (VA) Pharmacy | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2006-05-03 |
| 1114354537 | Emerling Inc | Department of Veterans Affairs (VA) Pharmacy | 102 W Park St, Taylorville, IL 62568-1547 | 2013-09-30 |
| 1518915172 | Chicago Vamc | Department of Veterans Affairs (VA) Pharmacy | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-05-05 |
| 1336197284 | Danville Vamc | Department of Veterans Affairs (VA) Pharmacy | 7717 N Orange Prairie Rd, Peoria, IL 61615-9323 | 2006-05-04 |
| 1750349429 | St. Louis Jc Vamc | Department of Veterans Affairs (VA) Pharmacy | 2401 W Main St, Marion, IL 62959-1188 | 2006-05-03 |
| 1326006933 | James A Lovell Federal Health Care Center | Department of Veterans Affairs (VA) Pharmacy | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2006-05-03 |
| 1508824418 | Danville Vamc | Department of Veterans Affairs (VA) Pharmacy | 1900 E Main St, Danville, IL 61832-5100 | 2006-05-02 |
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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.