THE MEDICINE SHOPPE
NPI 1417923012
Pharmacy - Community/Retail Pharmacy in Mount Vernon, IL

Q: What is Mt Vernon Community Pharmacy Inc's NPI number?

The NPI number for Mt Vernon Community Pharmacy Inc is 1417923012. It was assigned to this organization in the NPPES registry on February 24, 2006. The provider is doing business as The Medicine Shoppe.

Q: What is Mt Vernon Community Pharmacy Inc's specialty?

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

Q: What quality rating does Mt Vernon Community Pharmacy Inc have?

CMS rates Mount Vernon Health Care Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Active since February 24, 2006CLIA 14D2182519 · Waiver

1/5

Overall Rating

2339 BROADWAY ST, MOUNT VERNON, IL 62864(618) 242-8776 Get Directions Write a Review

NPPES record last updated: November 1, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About The Medicine Shoppe NPPES

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

THE MEDICINE SHOPPE (NPI 1417923012) is a healthcare organization registered as a community/retail pharmacy in Mount Vernon, Illinois and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Eric Black, Owner, as its authorized official.

NPPES Registry Identity

NPI1417923012

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameMT VERNON COMMUNITY PHARMACY INC

Location Address2339 BROADWAY STMount Vernon, IL 62864-2925

Mailing Address2339 Broadway StMount Vernon, IL 62864-2925 · (618) 242-8776

Phone(618) 242-8776

Organization SubpartNo

Authorized OfficialEric BlackOwner · (618) 242-8776

Enumeration DateFebruary 24, 2006

Last NPPES UpdateNovember 1, 2011

✔ NPI 1417923012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in IL · 054016737

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.

2339 BROADWAY ST, Mount Vernon, IL 62864

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Other Names 1

Doing Business AsThe Medicine Shoppe

Other Identifiers 5

Medicaid=========003IL

Other1447792Ncpdp Provider Identification Number

Medicare NSC0284160001IL

Other334555Healthlink

Other4132021Blue Cross Blue Shield

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 14D2182519

Mt Vernon Community Pharmacy · Mount Vernon, IL

Active · expires Apr 21, 2028

CLIA Number14D2182519

Laboratory TypePharmacy

Certificate Effective DateApril 22, 2026

Certificate Expiration DateApril 21, 2028

Laboratory DirectorEric L. Black

Laboratory Phone(618) 242-8776

Laboratory LocationMt Vernon Community Pharmacy2339 Broadway, Mount Vernon, IL 62864

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

207 services206 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

189 services189 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

13 services13 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

13 services13 patients

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Mount Vernon Health Care Center (CMS certification number 14E812), from CMS Care Compare.

Mount Vernon Health Care Center

Nursing home · Mount Vernon, IL

1/5 CMS Overall Rating

OwnershipFor profit - Corporation

CMS Certification Number14E812

Certified Beds106 beds41 residents per day on average

Medicare & Medicaid Participant SinceMarch 3, 1981

Resident & Family CouncilResident council

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

1/5

Long-Stay Quality

Quality of care delivered to long-term residents.

1/5

Staffing

Based on nursing staff hours relative to resident needs.

4/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

138.67

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 2.15 · LPN 0.66 · RN 0.63

3.44 hrs per resident per day

Weekend Nurse Staffing

3.06 hrs per resident per day

Physical Therapist Staffing

0 hrs per resident per day

Nursing Staff Turnover

Share of nursing staff who left the facility within the past year.

35.9%

Registered Nurse Turnover

60%

Administrators Who Have Left

In the past year.

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.

Facility-Reported Incidents

Substantiated Complaints

Fines

1 totaling $10,000.00

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 2

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

MR. ERIC LEE BLACK R.PH

Pharmacist

2339 BROADWAY ST
MOUNT VERNON, IL 62864

Jefferson County (618) 242-8776

MT VERNON COMMUNITY PHARMACY INC

Pharmacy (Long Term Care Pharmacy)

2339 BROADWAY ST
MOUNT VERNON, IL 62864

Jefferson County (618) 242-8776

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 Mt Vernon Community Pharmacy Inc's NPI number?

The NPI number for Mt Vernon Community Pharmacy Inc is 1417923012. It was assigned to this organization in the NPPES registry on February 24, 2006. The provider is doing business as The Medicine Shoppe.

Where is Mt Vernon Community Pharmacy Inc located?

Mt Vernon Community Pharmacy Inc is located at 2339 Broadway St, Mount Vernon, IL 62864. The listed phone number is (618) 242-8776.

What is Mt Vernon Community Pharmacy Inc's specialty?

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

Does Mt Vernon Community Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2182519) is associated with this NPI, valid through April 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Mt Vernon Community Pharmacy Inc a Medicare-certified nursing home?

Yes. Mount Vernon Health Care Center is a Medicare-certified nursing home with 106 certified beds.

What quality rating does Mt Vernon Community Pharmacy Inc have?

CMS rates Mount Vernon Health Care Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Mt Vernon Community Pharmacy Inc 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 49 other insurers list Mt Vernon Community Pharmacy Inc 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 Mt Vernon Community Pharmacy Inc was last updated on November 1, 2011. 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.