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ST JUDE PHARMACY INC. NPI 1790240489


NPI Information

NPI: 1790240489
Provider Name: ST JUDE PHARMACY, INC.

Doing Business As: ST. JUDE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 14D2174121

Address:
301 MADISON ST STE 114
JOLIET, IL
ZIP 60435
Phone: (815) 900-9000
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ST JUDE PHARMACY, INC. is a community/retail pharmacy pharmacy in Joliet, IL. The provider is 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. ST JUDE PHARMACY, INC. NPI is 1790240489. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Jude Pharmacy.

The provider's business location address is:

301 MADISON ST STE 114
JOLIET, IL
ZIP 60435-549
Phone: (815) 900-9000
Fax: (815) 900-5500

The provider's authorized official is Mohammed J Alahmed .
The authorized official title is Pharmacist In Charge and has the following contact phone number (815) 900-9000.

The CLIA number assigned to this NPI record is 14D2174121 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2019 and was last updated on 4/12/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyNo
23336S0011XPharmacySpecialty PharmacyNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4333600000XPharmacyNo
53336C0003XPharmacyCommunity/Retail PharmacyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1320012950OTHERILLINOISIDFPR ILLINOIC CONTROLLED PHARMACY LICENSE
2054021109OTHERILLINOISILLINOIS DEPARTMENT IF FINANCIAL AND PROFESSIONAL REGULATION PHARMACY LICENSE

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.