JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
NPI 1255609574
Non-Pharmacy Dispensing Site in Wood River, IL

Q: What is Jerseyville Pain Management Center, S.C.'s specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Active since December 01, 2011

1702 VAUGHN RD, WOOD RIVER, IL 62095(618) 259-3321 Get Directions Write a Review

NPPES record last updated: January 3, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Jerseyville Pain Management Center, S.c. NPPES

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

JERSEYVILLE PAIN MANAGEMENT CENTER, S.C. (NPI 1255609574) is a healthcare organization registered as a non-pharmacy dispensing site in Wood River, Illinois and active in the NPI registry since December 2011. The organization lists Bud Chomhirun, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1255609574

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameJERSEYVILLE PAIN MANAGEMENT CENTER, S.C.

Location Address1702 VAUGHN RDWood River, IL 62095-1898

Mailing Address2980 N Beverly Glen Cir, Suite 301Los Angeles, CA 90077-1726 · (310) 474-9809

Phone(618) 259-3321

Organization SubpartYes

Authorized OfficialBud ChomhirunMedical Director · (618) 259-3321

Enumeration DateDecember 1, 2011

Last NPPES UpdateJanuary 3, 2012

✔ NPI 1255609574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

1702 VAUGHN RD, Wood River, IL 62095

Open in Google Maps ↗

Other Providers at the Same Location NPPES 5

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

JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.

Chiropractor

1702 VAUGHN RD
WOOD RIVER, IL 62095

Madison County (618) 259-3321

JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.

Physical Medicine & Rehabilitation (Pain Medicine)

1702 VAUGHN RD
WOOD RIVER, IL 62095

Madison County (618) 259-3321

DR. WAK S CHIA M.D

Pediatrics

1702 VAUGHN RD
WOOD RIVER, IL 62095

Madison County (618) 259-5100

MRS. ERIN L MICENHEIMER PA-C

Physician Assistant (Medical)

1702 VAUGHN RD
WOOD RIVER, IL 62095

Madison County (618) 259-3321

DR. AARON JUSTIN MITCHELL D.C.

Chiropractor

1702 VAUGHN RD, SUITE 4
WOOD RIVER, IL 62095

Madison County (618) 259-3321

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 Jerseyville Pain Management Center, S.C.'s NPI number?

The NPI number for Jerseyville Pain Management Center, S.C. is 1255609574. It was assigned to this organization in the NPPES registry on December 1, 2011.

Where is Jerseyville Pain Management Center, S.C. located?

Jerseyville Pain Management Center, S.C. is located at 1702 Vaughn Rd, Wood River, IL 62095. The listed phone number is (618) 259-3321.

What is Jerseyville Pain Management Center, S.C.'s specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Jerseyville Pain Management Center, S.C. was last updated on January 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.