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General NPI Number Information
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NPI Number | 1518232669
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Entity Type | Organization
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Legal Business Name | PHARMA PLUS INC
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 10 ORLAND SQUARE DR STE 102
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City | ORLAND PARK
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State | IL
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Zip | 60462-3207
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Country | US
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Telephone | 708-949-8150
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Fax | 708-949-8047
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Provider Business Mailing Address
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Address Line | 10 ORLAND SQUARE DR SUITE 102
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City | ORLAND PARK
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State | IL
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Zip | 60462-3207
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Country | US
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Telephone | 708-949-8150
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Fax | 708-949-8047
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Authorized Official
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Title or Position | PIC/PRESIDENT
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Name | JALAL MATARIA
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Credential |
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Telephone | 708-949-8150
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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 | 054.017882
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License Number State | IL
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