SULLIVAN DRUGS INC (NPI# 1871578583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871578583 |
| Entity Type | Organization |
| Organization Name | SULLIVAN DRUGS INC |
| Other Organization Name | SULLIVANS DRUGS |
| Practice Address |
103 W Main St Mount Olive IL 62069 |
| Mailing Address |
Po Box 286 Mount Olive IL 62069-0286 |
| Practice Telephone | 2179997321 |
| Practice Fax Number | 2179993233 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2016-06-09 |
| Authorized Official Name | MAURICE SULLIVAN (PRESIDENT) |
| Authorized Official Telephone | 2178392909 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054003991 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023241 | 01 |
| Other Name | Type Code |
|---|---|
| SULLIVANS DRUGS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205900677 | Sullivan Drugs Inc | Pharmacy | 9563 Lavonia Rd, Carnesville, GA 30521-3254 | 2006-11-20 |
| 1134104219 | Sullivan Drugs Inc | Durable Medical Equipment & Medical Supplies | 113 S Macoupin St, Gillespie, IL 62033-1516 | 2005-12-12 |
| Street Address |
103 W MAIN ST |
| City | MOUNT OLIVE |
| State | IL |
| Zip Code | 62069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447399621 | Michael G Rademacher | Chiropractor | 106 East Main Street, Mt Olive, IL 62069 | 2007-02-05 |
| 1821440868 | Locust Street Resource Center Cila #2 | Clinic/Center | 202 E 3rd North St, Mount Olive, IL 62069-1320 | 2016-07-01 |
| 1073530887 | Mt. Olive Area Ambulance Service, Inc. | Ambulance | 815 W Main St, Mount Olive, IL 62069-1501 | 2006-07-16 |
| 1558312322 | Mount Olive Cu School Dist 5 | Local Education Agency (LEA) | 804 W Main St, Mt Olive, IL 62069-1549 | 2006-05-15 |
| 1275059784 | Jennifer Stockstill | Speech-Language Pathologist | 804 W Main St, Mount Olive, IL 62069-1549 | 2017-08-16 |
| 1477743342 | Macoupin Family Practice Centers, LLP | Family Medicine | 115 N Poplar St, Mount Olive, IL 62069-1613 | 2007-07-27 |
| 1881894533 | Macoupin Family Practice Centers, LLP | Family Medicine | 115 N Poplar St, Mount Olive, IL 62069-1613 | 2007-07-20 |
| 1275634131 | Dennis J. Guardia | Dentist | 312 W Main St, Mount Olive, IL 62069-1640 | 2006-09-25 |
| 1639588833 | Advanced Family Dental & Orthodontics of Mt. Olive, P.C. | Dentist | 312 W Main St, Mount Olive, IL 62069-1640 | 2014-08-13 |
| 1386145258 | Cindy Lee Bertolino | Nurse Practitioner | 9142 Prospect Rd, Mount Olive, IL 62069-2334 | 2018-02-26 |
| Find all providers in zip 62069 | ||||
| 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] |
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| 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 | ||||
| City | MOUNT OLIVE |
| Zip Code | 62069 |
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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.