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General NPI Number Information
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NPI Number | 1841477494
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Entity Type | Organization
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Legal Business Name | PYRAMID PHARMACEUTICAL GROUP
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 1177 N HIGHLAND AVE SUITE 203
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City | AURORA
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State | IL
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Zip | 60506-2281
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Country | US
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Telephone | 630-801-1700
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Fax | 630-801-1777
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Provider Business Mailing Address
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Address Line | 1177 N HIGHLAND AVE SUITE 203
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City | AURORA
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State | IL
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Zip | 60506-2281
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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 | PHARMACIST IN CHARGE
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Name | GABRIEL NWANDU
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Credential |
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Telephone | 630-801-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054016455
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License Number State | IL
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