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General NPI Number Information
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NPI Number | 1356700744
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Entity Type | Organization
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Legal Business Name | OAK LAWN HEALTH MART PHARMACY INC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 4700 W 95TH ST STE 101
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City | OAK LAWN
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State | IL
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Zip | 60453-2538
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Country | US
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Telephone | 708-443-4310
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Fax | 708-443-4311
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Provider Business Mailing Address
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Address Line | 4700 W 95TH ST STE 101
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City | OAK LAWN
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State | IL
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Zip | 60453-2538
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Country | US
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Telephone | 708-443-4310
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Fax | 708-443-4311
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Authorized Official
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Title or Position | OWNER, PIC, AO
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Name | HADIA ALHALABI
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Credential | RPH
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Telephone | 708-443-4310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054.019676
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License Number State | IL
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