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General NPI Number Information
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NPI Number | 1043486269
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Entity Type | Organization
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Legal Business Name | MARK DRUGS NORTHSHORE INC
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 1020 MILWAUKEE AVE STE 140
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City | DEERFIELD
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State | IL
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Zip | 60015-3513
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Country | US
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Telephone | 847-419-9898
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Fax | 847-419-9899
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Provider Business Mailing Address
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Address Line | 1020 MILWAUKEE AVE STE 140
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City | DEERFIELD
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State | IL
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Zip | 60015-3513
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Country | US
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Telephone | 847-419-9898
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Fax | 847-419-9899
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG BATOGOWSKI
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Credential | PHRMD
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Telephone | 630-699-2164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054016368
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License Number State | IL
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