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General NPI Number Information
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NPI Number | 1013688977
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Entity Type | Organization
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Legal Business Name | WHITING COMMUNITY PHARMACY INC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1236 119TH ST
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City | WHITING
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State | IN
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Zip | 46394-1640
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Country | US
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Telephone | 773-564-3669
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Fax |
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Provider Business Mailing Address
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Address Line | 505 E HOLLY AVE
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-2139
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Country | US
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Telephone | 773-564-3669
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMYRA MUHAMMAD
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Credential | PHARMD
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Telephone | 773-564-3669
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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 |
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