Groceries Of Southern Illinois LLC
Pharmacy, Community/Retail Pharmacy in Freeburg, IL. Organization (NPI-2).
NPI number1528073178
StatusActive
Last updated in NPPESJun 1, 2022
Details
- NPI
- 1528073178
- Entity type
- Organization (NPI-2)
- Legal business name
- Groceries Of Southern Illinois LLC
- Organization subpart
- No
- Enumeration date
- Jul 30, 2006
- Certification date
- Jun 1, 2022
- Last updated
- Jun 1, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 054009538 | IL | Yes |
| 333600000X | Pharmacy | – | – |
Other names
- Freeburg Pharmacy (Doing Business As)
Practice location
10 Southgate CtrFreeburg, IL 62243-1541
Phone 618-539-5577 · Fax 618-539-3089
Mailing address
Po Box 140Columbia, IL 62236-0140
Phone 618-539-5577 · Fax 618-539-3089
Authorized official
Bryan Victor Schneider
Director Of Pharmacy
6182073186
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