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BOARD OF TRUSTEES FOR EASTERN ILLINOIS UNIVERSITY NPI 1457434532


NPI Information

NPI: 1457434532
Provider Name: BOARD OF TRUSTEES FOR EASTERN ILLINOIS UNIVERSITY

Doing Business As: EASTERN IL UNIVERSITY PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
1102 HUMAN SERVICES BUILDING
600 LINCOLN AVE
CHARLESTON, IL
ZIP 61920
Phone: (217) 581-7779
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BOARD OF TRUSTEES FOR EASTERN ILLINOIS UNIVERSITY is a clinic pharmacy pharmacy in Charleston, IL. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. BOARD OF TRUSTEES FOR EASTERN ILLINOIS UNIVERSITY NPI is 1457434532. The provider is registered as an organization entity type.
The provider Is Doing Business As Eastern Il University Pharmacy.

The provider's business location address is:

1102 HUMAN SERVICES BUILDING
600 LINCOLN AVE
CHARLESTON, IL
ZIP 61920
Phone: (217) 581-7779
Fax: (217) 581-7780

The provider's authorized official is Amy Malmen .
The authorized official title is Pharm Supv and has the following contact phone number (217) 581-7779.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 3/1/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0002XPharmacyClinic Pharmacy054017107ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12018991OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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