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AXLINE PHARMACY 03
NPI 1104302249
Pharmacy - Community/Retail Pharmacy in Roanoke, IL

Active since July 12, 2018CLIA 14D2181635 · Waiver
322 N MAIN ST, ROANOKE, IL 61561(309) 923-7711(309) 923-7714 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Axline Pharmacy 03 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AXLINE PHARMACY 03 (NPI 1104302249) is a healthcare organization registered as a community/retail pharmacy in Roanoke, Illinois and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through April 7, 2028 and lists Troy Williams, Rph/owner, as its authorized official.

NPPES Registry Identity

NPI1104302249
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameROANOKE RX LLC
Location Address322 N MAIN STRoanoke, IL 61561-7515
Mailing AddressPo Box 1087Bloomington, IL 61702-1087 · (309) 828-6767 · Fax (309) 828-6970
Phone(309) 923-7711
Fax(309) 923-7714
Organization SubpartYes
Authorized OfficialTroy WilliamsRph/owner · (309) 660-5939
Enumeration DateJuly 12, 2018
Last NPPES UpdateMarch 16, 2022
NPPES CertifiedMarch 16, 2022
✔ NPI 1104302249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
Also ListedPharmacyTaxonomy 333600000X · License 054020855 (IL)
322 N MAIN ST, Roanoke, IL 61561
Open in Google Maps ↗

Other Names 1

Doing Business AsAxline Pharmacy 03

Other Identifiers 1

Other1494450IL · Ncpdp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2181635

Axline Pharmacy (05) · Bloomington, IL
Active · expires Apr 7, 2028
CLIA Number14D2181635
Laboratory TypePharmacy
Certificate Effective DateApril 8, 2026
Certificate Expiration DateApril 7, 2028
Laboratory DirectorTroy L. Williams
Laboratory Phone(309) 828-6767
Laboratory LocationAxline Pharmacy (05)1210 Towanda Ave - Ste 11, Bloomington, IL 61701
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEVEN LEE CRAWFORD R. PH.
Pharmacist
322 N MAIN ST
ROANOKE, IL 61561
Woodford County (309) 923-7431

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roanoke Rx LLC's NPI number?

The NPI number for Roanoke Rx LLC is 1104302249. It was assigned to this organization in the NPPES registry on July 12, 2018. The provider is doing business as Axline Pharmacy 03.

Where is Roanoke Rx LLC located?

Roanoke Rx LLC is located at 322 N Main St, Roanoke, IL 61561. The listed phone number is (309) 923-7711.

What is Roanoke Rx LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Roanoke Rx LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2181635) is associated with this NPI, valid through April 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Roanoke Rx LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Roanoke Rx LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roanoke Rx LLC was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.