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General NPI Number Information
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NPI Number | 1376504829
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Entity Type | Organization
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Legal Business Name | ELGIN CENTER PHARMACY INC
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 901 CENTER ST STE 200
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City | ELGIN
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State | IL
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Zip | 60120-2104
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Country | US
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Telephone | 847-697-1600
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Fax | 847-697-1612
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Provider Business Mailing Address
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Address Line | 901 CENTER ST STE 200
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City | ELGIN
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State | IL
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Zip | 60120-2104
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Country | US
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Telephone | 847-697-1600
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Fax | 847-697-1612
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Authorized Official
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Title or Position | SECRETARY
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Name | ARVIND SURTI
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Credential | RPH
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Telephone | 847-488-9273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054015787
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License Number State | IL
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