ST JUDE PHARMACY, INC. (NPI# 1790240489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790240489 |
Entity Type | Organization |
Organization Name | ST JUDE PHARMACY, INC. |
Other Organization Name | ST. JUDE PHARMACY |
Practice Address |
301 Madison St Ste 114 Joliet IL 60435-6549 |
Practice Telephone | 8159009000 |
Practice Fax Number | 8159005500 |
Mailing Telephone | 8159009000 |
Mailing Fax Number | 8159005500 |
Enumeration Date | 2019-02-06 |
Last Update Date | 2019-04-12 |
Authorized Official Name | MOHAMMED J ALAHMED (PHARMACIST IN CHARGE) |
Authorized Official Telephone | 8159009000 |
Authorized Official Credential | RPH. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | IDFPR ILLINOIC CONTROLLED PHARMACY LICENSE | 320012950 | 01 |
IL | ILLINOIS DEPARTMENT IF FINANCIAL AND PROFESSIONAL REGULATION PHA | 054021109 | 01 |
Other Name | Type Code |
---|---|
ST. JUDE PHARMACY | Doing Business As Name - Organization |
Street Address |
301 MADISON ST STE 114 |
City | JOLIET |
State | IL |
Zip Code | 60435-6549 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285820605 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 301 Madison St Ste 114, Joliet, IL 60435-6549 | 2007-09-19 |
1447533823 | John Michael Egner | Pharmacist | 301 Madison St Ste 114, Joliet, IL 60435-6549 | 2011-09-22 |
1124306741 | Mohammed J Alahmed | Pharmacist | 301 Madison St Ste 114, Joliet, IL 60435-6549 | 2011-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851889018 | Chime Ajiere | Nurse Practitioner | 511 Theodore St, Joliet, IL 60435 | 2018-04-24 |
1740791284 | Melanie Presnak | Speech-Language Pathologist | 1207 N Larkin Ave, Joliet, IL 60435 | 2017-10-23 |
1831618883 | Jeriel Marsena Quarles | Licensed Practical Nurse | 1617 W Jefferson Street, Joliet, IL 60435 | 2017-09-11 |
1053769760 | Cody Hutchinson | Physical Therapy Assistant | 2943 W Jefferson St, Joliet, IL 60435 | 2016-06-03 |
1659748549 | Megan Ryab | Massage Therapist | 501 Wilcox St, Joliet, IL 60435 | 2015-08-26 |
1922416197 | Kodo Care, Inc. | Pharmacy | 221 Springfield Avenue, Suite A, Joliet, IL 60435 | 2014-07-31 |
1528489739 | My Family Doc LLC | Family Medicine | 2001-03 Essington Rd, Joliet, IL 60435 | 2013-12-16 |
1184973869 | R A Lombardi Dds PC | Dentist | 3011 Theodore St., Joliet, IL 60435 | 2012-09-10 |
1245546076 | Kelly Rae Lesemann | Chiropractor | 1011 Essington Road, Joliet, IL 60435 | 2010-08-31 |
1932413697 | Ann E Todd | Optometrist | 1521 Essington Road, Everything In Sight, Joliet, IL 60435 | 2010-08-04 |
Find all providers in zip 60435 |
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 |
---|---|---|---|---|
1518171313 | Essington Pharmacy | Pharmacy | 2202 Essington Rd Ste 102, Joliet, IL 60435-1634 | 2007-05-10 |
1124126966 | Highland Park Cvs LLC | Pharmacy | 3200 Caton Farm, Joliet, IL 60431 | 2006-09-20 |
1538175906 | Walgreen Co | Pharmacy | 1801 Ingalls Ave, Joliet, IL 60435-7903 | 2006-07-31 |
1033132311 | Highland Park Cvs LLC | Pharmacy | 2701 Plainfield Rd, Joliet, IL 60435-1166 | 2006-07-26 |
1235458910 | Basinger's Madison Pharmacy | Pharmacy | 330 Madison St, Suite 102, Joliet, IL 60435-6565 | 2010-05-20 |
1700039120 | Bubblepack Pharmacy Inc | Pharmacy | 2202 Essington Rd, Ste 104, Joliet, IL 60435-1634 | 2008-10-29 |
1649331711 | Primary Pharmacy Inc | Pharmacy | 2025 S Chicago St, Joliet, IL 60436-3172 | 2006-12-13 |
1932281722 | Basingers Pharmacy Inc | Pharmacy | 300 N Ottawa St, Joliet, IL 60432-4009 | 2006-10-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
Find all providers with the same taxonomy |
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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.