Isu Student Health Service Pharmacy

LBN: Illinois State University
Isu Student Health Service Pharmacy is an health care organization with primary practice located at 201 N. University St , Normal IL 61790. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Illinois State University can be contacted via phone (309) 438-8713, or through Rupert, Marie via phone (309) 438-8713.

Contact Information

Primary practice address
201 N. University St Normal IL 61790
Phone: (309) 438-8713
Fax: (309) 438-7569
Website:
Map and Directions
Authorized official contact:
Name: Rupert, Marie PHARMD
Phone: (309) 438-8713

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 054017028 Illinois

Profile Details

NPI number 1952460388
LBN Legal business name Illinois State University
DBA Doing business as Isu Student Health Service Pharmacy
Authorized official Rupert, Marie PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 8th, 2006
Last updated Mar 23rd, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952460388 NPPES
Other 2021237 PK
MEDICAID 1999303700 PK

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