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JAVON BEA HOSPITAL NPI 1144790791


NPI Information

NPI: 1144790791
Provider Name: JAVON BEA HOSPITAL

Doing Business As: MERCYHEALTH PHARMACY - RIVERSIDE

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 14D2156625

Address:
8201 E RIVERSIDE BLVD STE 1022
ROCKFORD, IL
ZIP 61114
Phone: (815) 971-1100
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JAVON BEA HOSPITAL is a pharmacy in Rockford, IL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. JAVON BEA HOSPITAL NPI is 1144790791. The provider is registered as an organization entity type.
The provider Is Doing Business As Mercyhealth Pharmacy - Riverside.

The provider's business location address is:

8201 E RIVERSIDE BLVD STE 1022
ROCKFORD, IL
ZIP 61114-300
Phone: (815) 971-1100
Fax: (815) 971-9084

The provider's authorized official is James Nemeth .
The authorized official title is Vp Finance/cfo and has the following contact phone number (608) 756-6000.

The CLIA number assigned to this NPI record is 14D2156625 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/27/2018 and was last updated on 7/24/2019.


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
13336C0003XPharmacyCommunity/Retail PharmacyNo
2333600000XPharmacyYes

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
11494842OTHERNCPDP
2054020724OTHERILLINOISIL STATE 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: 11/14/2023

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.