Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
ILLINI PHARMACY SERVICES LLC
Active
Organization
ILLINI PHARMACY SERVICES LLC
Active
Other names
Illini Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN SHASTEEN BS PHARMACY (OWNER)
(217) 791-6340
Entity
Organization
Contact information
Practice address
675 W IMBODEN DR, DECATUR, IL 62521-9068
(217) 791-6340
(217) 791-6568
Mailing address
675 W IMBODEN DR, DECATUR, IL 62521-9068
(217) 791-6340
(217) 791-6568
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
054.017565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127198
PK
—
Enumeration date
10/15/2010
Last updated
02/21/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up