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General NPI Number Information
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NPI Number | 1972926244
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Entity Type | Organization
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Legal Business Name | DESNA PHARMACY, INC.
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Dates
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Enumeration Date | 01/22/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 307 S MILWAUKEE AVE SUITE 109
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City | WHEELING
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State | IL
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Zip | 60090-5076
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Country | US
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Telephone | 847-229-5477
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Fax | 847-229-8448
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Provider Business Mailing Address
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Address Line | 843 TALL GRASS LN
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City | MUNDELEIN
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State | IL
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Zip | 60060-4565
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Country | US
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Telephone | 847-845-2180
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MARINA FEFERMAN
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Credential |
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Telephone | 847-845-2180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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 | IL
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | IL
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