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General NPI Number Information
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NPI Number | 1528531902
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Entity Type | Organization
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Legal Business Name | PIPELINE MIDWEST PHARMACIES, LLC
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 1111 SUPERIOR ST
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City | MELROSE PARK
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State | IL
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Zip | 60160-4138
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Country | US
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Telephone | 708-938-7213
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Fax |
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Provider Business Mailing Address
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Address Line | 4646 N MARINE DR
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City | CHICAGO
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State | IL
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Zip | 60640-5759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAMES EDWARDS
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Credential |
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Telephone | 570-436-8540
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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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