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General NPI Number Information
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NPI Number | 1588716831
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Entity Type | Organization
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Legal Business Name | FAMILY FARMACIA INC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 4242 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60639-3647
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Country | US
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Telephone | 773-227-8874
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Fax | 773-227-8284
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Provider Business Mailing Address
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Address Line | 4242 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60639-3647
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Country | US
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Telephone | 773-227-8874
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Fax | 773-227-8284
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAHENDRA PATEL
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Credential | RPH
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Telephone | 773-227-8874
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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 | 054009199
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License Number State | IL
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