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NPI Code Detail

MEDICARE: ELGIN CENTER PHARMACY INC

MEDICARE: ELGIN CENTER PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy054015787IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12021907OTHERPK

General Provider Information

NPI Number : 1376504829
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELGIN CENTER PHARMACY INC
Provider Business Mailing Address
First Line : 901 CENTER ST
Second Line : STE 200
City : ELGIN
State : IL
Zip : 60120-2104
Country : US
Telephone Number : 847-697-1600
Fax Number : 847-697-1612
Provider Business Practice Location Address
First Line : 901 CENTER ST
Second Line : STE 200
City : ELGIN
State : IL
Zip : 60120-2104
Country : US
Telephone Number : 847-697-1600
Fax Number : 847-697-1612
Authorized Official
Title or Position : SECRETARY
Name : ARVIND SURTI
Credential : RPH
Telephone Number : 847-488-9273
Provider Enumeration Date : 03/31/2006
Last Update Date : 06/17/2014

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Directions to “ELGIN CENTER PHARMACY INC ” Practice Location

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