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NPI Code Detail

MEDICARE: AMERICAN PHARMACY INC

MEDICARE: AMERICAN PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0002XClinic Pharmacy
33336C0004XCompounding Pharmacy
43336C0003XCommunity/Retail Pharmacy054.016407IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11482241OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1366603094
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN PHARMACY INC
Provider Business Mailing Address
First Line : 583 WILSON AVE
Second Line :
City : GLEN ELLYN
State : IL
Zip : 60137-6266
Country : US
Telephone Number : 630-886-9290
Fax Number : 773-298-8755
Provider Business Practice Location Address
First Line : 9718 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60628-1007
Country : US
Telephone Number : 773-298-8750
Fax Number : 773-298-8755
Authorized Official
Title or Position : PRESIDENT
Name : OM DHINGRA
Credential : RPH
Telephone Number : 773-298-8750
Provider Enumeration Date : 06/25/2008
Last Update Date : 01/04/2012

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Directions to “AMERICAN PHARMACY INC ” Practice Location

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