Provider Demographics
NPI:1902990310
Name:HUGO H ORLANDINI JR
Entity Type:Organization
Organization Name:HUGO H ORLANDINI JR
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:H
Authorized Official - Last Name:ORLANDINI
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:217-824-2288
Mailing Address - Street 1:102 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62568-1547
Mailing Address - Country:US
Mailing Address - Phone:217-824-2288
Mailing Address - Fax:217-287-7422
Practice Address - Street 1:102 W PARK ST
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568-1547
Practice Address - Country:US
Practice Address - Phone:217-824-2288
Practice Address - Fax:217-287-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0548504333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1449936OtherOTHER ID NUMBER-COMMERCIAL NUMBER
ILAT3070199OtherDEA #
IL=========001Medicaid
IL0425590001Medicare NSC
IL208230Medicare PIN
1449936OtherOTHER ID NUMBER-COMMERCIAL NUMBER