=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568083301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POINTCORE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2020
-----------------------------------------------------
Last Update Date | 07/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 N KNOXVILLE AVE STE G
-----------------------------------------------------
City | PEORIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61603-3028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-308-2400
-----------------------------------------------------
Fax | 309-308-2401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 SW ADAMS ST
-----------------------------------------------------
City | PEORIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61602-1308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO, OSF HEALTHCARE SYSTEM
-----------------------------------------------------
Name | ROBERT CARL SEHRING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 309-655-7689
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------