Healthcare Provider Details

I. General information

NPI: 1922398791
Provider Name (Legal Business Name): ALLCARE DISCOUNT PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 W NORTH AVE
CHICAGO IL
60647-5247
US

IV. Provider business mailing address

2750 W NORTH AVE
CHICAGO IL
60647-5247
US

V. Phone/Fax

Practice location:
  • Phone: 312-432-4510
  • Fax: 773-278-1836
Mailing address:
  • Phone: 312-432-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054.017654
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HIREN ZALA
Title or Position: PHARMACY MANAGER
Credential:
Phone: 312-432-4510