MEDICARE: SHREE PHARMACY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	3336C0002X	Clinic Pharmacy
3	3336H0001X	Home Infusion Therapy Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2021159	OTHER		PK

General Provider Information

NPI Number	:	1437164084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHREE PHARMACY INC

Provider Business Mailing Address
First Line	:	1624 W MONTROSE AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1214
Country	:	US
Telephone Number	:	773-907-0407
Fax Number	:	773-907-0560

Provider Business Practice Location Address
First Line	:	1624 W MONTROSE AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1214
Country	:	US
Telephone Number	:	773-907-0407
Fax Number	:	773-907-0560

Authorized Official
Title or Position	:	SECRETARY
Name	:	KIRAN KUMAR CHENNA
Credential	:
Telephone Number	:	551-998-2115

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	12/02/2024

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Directions to “SHREE PHARMACY INC ” Practice Location

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