PHARMACY
NPI 1104089804
Pharmacy in Pinckneyville, IL

NPI Status: Active since July 03, 2008

Contact Information

101 N WALNUT ST
PINCKNEYVILLE, IL
ZIP 62274
Phone: (618) 357-2187
Fax: (618) 357-6740

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Pharmacy
CLIA Number: 14D0922679
CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
CLIA Exp. Date: 12-03-2026

About PHARMACY

This page provides the complete NPI Profile along with additional information for Pharmacy, a provider established in Pinckneyville, Illinois operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1104089804 assigned on July 2008. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Pharmacy. The authorized official of this NPI record is Kara Jo Carson (Cfo)

NPI: 1104089804
Provider Legal Name: PINCKNEYVILLE COMMUNITY HOSPITAL
Other Organization Name: PHARMACY
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 101 N WALNUT ST PINCKNEYVILLE, IL 62274
Location Phone: (618) 357-2187
Location Fax: (618) 357-6740
Mailing Address: 101 N WALNUT ST PINCKNEYVILLE, IL 62274
Mailing Phone: (618) 357-2187
Mailing Fax: (618) 357-6740
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 07-03-2008
Last Update Date: 07-03-2008
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Pharmacy
Taxonomy Code: 333600000X
Type: Suppliers
Taxonomy Description: 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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: KARA JO CARSON
Authorized Official Title: CFO
Authorized Official Phone: (618) 357-2187

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
=========6227402	MEDICAID (05)	IL

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 14D0922679
Facility Type: Skilled Nursing Facility/Nursing Facility
Certificate Effective Date: December 04, 2024
Certificate Expiration Date: December 03, 2026
Laboratory Director: EVA HOPP
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104089804, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 18 → 1 + 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 0 → 0 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 0 + 8 + 1 + 8 + 8 + 0 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4

This NPI is valid

The calculated check digit is 4, which matches the last digit of 1104089804.