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General NPI Number Information
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NPI Number | 1346787058
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Entity Type | Organization
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Legal Business Name | BELMONT & WESTERN FARMACIA LLC
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 2212 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6421
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Country | US
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Telephone | 773-880-5544
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Fax | 773-880-1033
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Provider Business Mailing Address
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Address Line | 2212 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6421
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Country | US
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Telephone | 773-880-5544
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Fax | 773-880-1033
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. KAMLESH P SHETH
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Credential | PHARMACIST
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Telephone | 773-880-5544
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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 | 051-033155
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License Number State | IL
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