Healthcare Provider Details

I. General information

NPI: 1962952283
Provider Name (Legal Business Name): BASINGER'S PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 NEAL AVE
JOLIET IL
60433-2548
US

IV. Provider business mailing address

1106 NEAL AVE
JOLIET IL
60433-2548
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-1102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HARISH BHATT
Title or Position: PRESIDENT
Credential:
Phone: 815-725-1102