Healthcare Provider Details
I. General information
NPI: 1952766743
Provider Name (Legal Business Name): OMKAR PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2015
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1835 N 19TH AVE SUITE 101
MELROSE PARK IL
60160
US
IV. Provider business mailing address
1835 N 19TH AVE SUITE 101
MELROSE PARK IL
60160
US
V. Phone/Fax
- Phone: 888-486-8002
- Fax: 855-788-4780
- Phone: 888-486-8002
- Fax: 855-788-4780
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDSAY
CUNNINGHAM
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 248-515-4439