OSCO DRUG #0122 – Community/Retail Pharmacy, NPI 1962458596

OSCO DRUG #0122 is a healthcare provider. based in Moline, Illinois. specializing in Community/Retail Pharmacy. The organization holds a License No. 054-005378 (IL). The NPI Number for OSCO DRUG #0122 is 1962458596

Main info

Organization
Name
OSCO DRUG #0122
NPI
1962458596
Phone
(309) 797-9320
Address
2014 1ST STREET A
Authorized Official
TIFFANY ELIOPULOS ASSISTANT MANAGER, ENROLLMENTS
Enumeration Date
25 May 2006
Last Update Date
20 July 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for OSCO DRUG #0122

  • 1st Street A, Moline, Rock Island County, Illinois, 61244, United States

    MOLINE, IL 61265

    Phone: (309) 797-9320

    Fax: (309) 797-0199

    Type: Location

  • 250, East Parkcenter Boulevard, Boise, Ada County, Idaho, 83706, United States

    MAILSTOP SEC2-B

    BOISE, ID 837063940

    Phone:

    Type: Mailing

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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (585 days ago).

Enrollment records

1

Earliest due date

2024-10-31

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
O20100930064218OPharmacyIL2024-10-31

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61265)

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Reviews

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Frequently asked questions

How is OSCO DRUG #0122 identified in CMS data?
CMS-hosted NPPES data lists OSCO DRUG #0122 with NPI 1962458596.
Does CMS list OSCO DRUG #0122 as active?
Yes — OSCO DRUG #0122 is active in the NPI listing used on this page.
What is OSCO DRUG #0122's specialty?
The listing groups OSCO DRUG #0122 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where is OSCO DRUG #0122 based?
OSCO DRUG #0122 is tied to Moline, Illinois in the data we show; additional addresses may exist on the full record.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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