PLUM STREET PHARMACY NPI 1619245404

NPI Information

  • NPI: 1619245404
  • Provider Name: PLUM STREET PHARMACY
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: PLUM STREET PHARMACY
  • Address: 311 PLUM ST
    CARMI, IL
    ZIP 62821
  • Phone: (618) 382-8400

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NPI Details

PLUM STREET PHARMACY is a community/retail pharmacy pharmacy in Carmi, 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. PLUM STREET PHARMACY NPI is 1619245404. The provider is registered as an organization entity type.
The provider Is Doing Business As Plum Street Pharmacy.

The provider's business location address is:

311 PLUM ST
CARMI, IL
ZIP 62821-632
Phone: (618) 382-8400
Fax: (618) 382-5700

The provider's authorized official is Don Gee .
The authorized official title is Pharmacist/owner and has the following contact phone number (618) 382-8330.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)

The enumeration date for this NPI number is 12/7/2011 and was last updated on 3/9/2015.

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
13336L0003XPharmacyLong Term Care PharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy054.017833ILLINOISYes

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
12132742OTHERPK
26741300001MEDICARE NSC
3349683015001MEDICAIDILLINOIS

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: 11/21/2025

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