Healthcare Provider Details
I. General information
NPI: 1275642829
Provider Name (Legal Business Name): HEALYS EDWARD CAMPUS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 SPALDING DR # 101
NAPERVILLE IL
60540
US
IV. Provider business mailing address
100 SPALDING DR
NAPERVILLE IL
60540
US
V. Phone/Fax
- Phone: 630-357-2900
- Fax: 630-357-2989
- Phone: 630-357-2900
- Fax: 630-357-2989
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: MR.
THOMAS
ALDEN
HEALY
Title or Position: PRESIDENT
Credential:
Phone: 630-357-2900