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General NPI Number Information
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NPI Number | 1013032986
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Entity Type | Organization
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Legal Business Name | BELMONT PHARMACY
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6148 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-4003
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Country | US
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Telephone | 773-777-9624
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Fax | 773-777-9625
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Provider Business Mailing Address
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Address Line | 6148 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-4003
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Country | US
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Telephone | 773-777-9624
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Fax | 773-777-9625
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL MARKIEWICZ
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Credential | PHARM.D.
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Telephone | 773-777-9624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | IL
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