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General NPI Number Information
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NPI Number | 1447393509
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Entity Type | Organization
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Legal Business Name | DESAI PHARMACY INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 2859 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60623-4456
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Country | US
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Telephone | 773-522-2900
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Fax | 773-522-3385
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Provider Business Mailing Address
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Address Line | 2859 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60623-4456
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Country | US
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Telephone | 773-522-2900
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Fax | 773-522-3385
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Authorized Official
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Title or Position | PRESIDENT
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Name | NARENDRA DESAI
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Credential | RPH
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Telephone | 773-522-2900
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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 | 054.015085
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License Number State | IL
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