Shawnee Health Service And Development Corp
Federally Qualified Health Center (FQHC)
109 California St, Carterville
Illinois, 62918-0577
618-985-8221 618-985-6860
Shawnee Health Service And Development Corp is a Federally Qualified Health Center (FQHC) in Carterville, Illinois. It is located at 109 California St, Carterville and it's customer support contact number is 618-985-8221. The authorized person of Shawnee Health Service And Development Corp is Christina Carney who is Ceo of the pharmacy and his contact number is 618-956-9521. Shawnee Health Service And Development Corp accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Shawnee Health Service And Development Corp is definition to come...
Pharmacy Details:
Shawnee Health Service And Development Corp type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Shawnee Health Service And Development Corp |
| Type: | Federally Qualified Health Center (FQHC) |
| Location: | 109 California St, Carterville,
Illinois, 62918-0577 |
| Phone: | 618-985-8221 |
| Fax: | 618-985-6860 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Christina Carney |
| Position: | Ceo |
| Contact Number: | 618-956-9521 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1639295314 |
| NPI Enumeration Date: | 22 Mar, 2007 |
| NPI Last Update On: | 05 Apr, 2024 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Shawnee Health Service And Development Corp are as mentioned below.
| Specialization | License Number | State | Status | |
| Federally Qualified Health Center (FQHC) | | | Primary | |
| Clinical | | Illinois | Secondary | |
| Dentist | | Illinois | Secondary | |
| Dental Hygienist | | Illinois | Secondary | |
| Dental Assistant | | Illinois | Secondary | |
| Dietitian, Registered | | Illinois | Secondary | |
| Family Medicine | | Illinois | Secondary | |
| Adolescent Medicine | | Illinois | Secondary | |
| Pulmonary Disease | | Illinois | Secondary | |
| Obstetrics & Gynecology | | Illinois | Secondary | |
| Pediatrics | | Illinois | Secondary | |
| Neurology | | Illinois | Secondary | |
| Community/Retail Pharmacy | | Illinois | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 022 | Medicaid | Illinois | |
| 020 | Medicaid | Illinois | |
| 640701 | Other | | Medicare Part B Group Id |
| 10032052 | Other | Illinois | Blue Cross Blue Shield |
| CF3444 | Other | Illinois | Medicare Railroad |
| 013 | Medicaid | Illinois | |
| 024 | Medicaid | Illinois | |
| 018 | Medicaid | Illinois | |
| 019 | Medicaid | Illinois | |
Medicare Enrollment:
Shawnee Health Service And Development Corp is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1658285671 | O20031120000454 | Shawnee Health Service And Development Corp | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 109 California St, P O Box 577
Carterville, Illinois |
| Zip: | 62918-0577 |
| Phone Number: | 618-985-8221 |
| Fax Number: | 618-985-6860 |
Patients can reach Shawnee Health Service And Development Corp at
109 California St, Carterville, Illinois or can
call on customer care at 618-985-8221.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.