Byrd-Watson Pharmacy – Community/Retail Pharmacy, NPI 1598775413

Byrd-Watson Pharmacy is a healthcare provider. based in Mount vernon, Illinois. specializing in Community/Retail Pharmacy. The organization holds a License No. 054009959 (IL). The NPI Number for Byrd-Watson Pharmacy is 1598775413

Main info

Organization
Name
Byrd-Watson Pharmacy
NPI
1598775413
Phone
(618) 244-5400
Address
PO BOX 1179
Authorized Official
ADAM BREEZE OFFICER OF THE CORPORATION
Enumeration Date
9 August 2006
Last Update Date
8 April 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness80
Years active:19State licenses:2Digital endpointsUpdated within 12 months

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Provider Addresses for Byrd-Watson Pharmacy

  • Mount Vernon Post Office, South 1st Avenue, Parkside, City of Mount Vernon, Westchester County, New York, 10550, United States

    MOUNT VERNON, IL 628640024

    Phone: (618) 244-5400

    Fax: (618) 244-5409

    Type: Mailing

  • 3401, Broadway Street, Mount Vernon, Jefferson County, Illinois, 62864, United States

    MOUNT VERNON, IL 628642201

    Phone: (618) 244-5400

    Fax: (618) 244-5988

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (895 days ago).

Enrollment records

3

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930021593OPharmacyIL2026-09-30
O20141104001481OMass Immunization (Roster Biller Only)IL2025-10-31
O20181213000097OPharmacyIL2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count83298$0
G0008Administration of influenza virus vaccine308306$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage287286$0
90480Admn sarscov2 vacc 1 dose105105$0
91322Sarscov2 vac 50 mcg/0.5ml im7878$0
View full utilization report →

Insurance plans in this area (ZIP 62864)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Byrd-Watson Pharmacy?
Byrd-Watson Pharmacy — NPI 1598775413 — is the standard way to identify this listing.
Does the file indicate Byrd-Watson Pharmacy is practicing under active NPI?
Directory data currently reports Byrd-Watson Pharmacy as active.
What is Byrd-Watson Pharmacy best known for clinically?
Directory data describes Byrd-Watson Pharmacy with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Does Byrd-Watson Pharmacy list a practice location?
Patients near Mount Vernon, Illinois may find Byrd-Watson Pharmacy in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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