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General NPI Number Information
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NPI Number | 1063623908
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Entity Type | Organization
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Legal Business Name | PHARMACIA EL AMANECER, INC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 1842 S BLUE ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60608-3013
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Country | US
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Telephone | 312-850-9686
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Fax | 312-850-9697
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Provider Business Mailing Address
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Address Line | 1842 S BLUE ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60608-3013
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Country | US
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Telephone | 312-850-9686
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Fax | 312-850-9697
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KISHORE B PUROHIT
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Credential |
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Telephone | 312-850-9686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | IL
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