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General NPI Number Information
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NPI Number | 1275711533
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Entity Type | Organization
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Legal Business Name | REGIONAL PHARMACY INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 5544 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4129
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Country | US
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Telephone | 773-685-5600
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Fax | 773-685-5605
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Provider Business Mailing Address
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Address Line | 5544 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4129
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PRASHANI PATEL
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Credential | PHRMD
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Telephone | 847-585-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 54016364
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License Number State | IL
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