OrganizationActive
Byrd-Watson Times Square Drug Co
NPI 1043997182 · Long Term Care Pharmacy · Mount Vernon, IL
Provider details
- NPI number
- 1043997182
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Adam Breeze, Officer of the Corporation(618) 244-5400
Specialties & taxonomies
Suppliers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3401 Broadway St
Mount Vernon, IL 62864-2201
Phone: (618) 244-5400
Street-level locationGet directions
Mailing address
Po Box 1179
Mount Vernon, IL 62864-0024
Other names (DBA / former)
- Doing business as
- Byrd-Watson Pharmacy Ltc
Registry dates
- Enumerated
- 2023-06-30
- Last updated
- 2025-04-08
- Certified
- 2025-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.