OrganizationActiveAccepts Medicare
Pbcc Pharmacy LLC
NPI 1366070476 · Pharmacy · Springfield, IL
Enrolled with Medicare as Part B Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1366070476
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Osvaldo Wesly, Medical Director(217) 414-1041
Specialties & taxonomies
Suppliers
- Specialty Pharmacy3336S0011X
Suppliers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
1500 W Washington St Ste B
Springfield, IL 62702-4756
Phone: (217) 546-7100
Street-level locationGet directions
Mailing address
105 S Amos Ave
Springfield, IL 62704-1528
Registry dates
- Enumerated
- 2020-04-01
- Last updated
- 2025-04-07
- Certified
- 2025-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.