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General NPI Number Information
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NPI Number | 1952442568
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Entity Type | Organization
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Legal Business Name | LINCOLN MEDICAL APOTHECARY, INC.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 157 S LINCOLN AVE
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City | AURORA
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State | IL
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Zip | 60505-4264
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Country | US
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Telephone | 630-892-7777
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Fax | 630-892-7787
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Provider Business Mailing Address
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Address Line | 157 S LINCOLN AVE
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City | AURORA
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State | IL
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Zip | 60505-4264
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Country | US
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Telephone | 630-892-7777
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Fax | 630-892-7787
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN O'DWYER JR.
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Credential |
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Telephone | 630-892-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 13884
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 013884
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License Number State | IL
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