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
PAVILION PHARMACY LLC
Active
Organization
PAVILION PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUIN HOSTETLER (MANAGER)
(217) 789-4355
Entity
Organization
Contact information
Practice address
301 N 8TH ST, STE 1A106, SPRINGFIELD, IL 62701-1041
(217) 789-4355
(217) 789-0129
Mailing address
301 N 8TH ST, STE 1A106, SPRINGFIELD, IL 62701-1041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1458442
OTHER ID NUMBER
—
Enumeration date
02/01/2006
Last updated
04/20/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers