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NPI Code Detail

MEDICARE: DESAI PHARMACY INC

MEDICARE: DESAI 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 Pharmacy054.015085IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12021500OTHERPK

General Provider Information

NPI Number : 1447393509
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESAI PHARMACY INC
Provider Business Mailing Address
First Line : 2859 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4456
Country : US
Telephone Number : 773-522-2900
Fax Number : 773-522-3385
Provider Business Practice Location Address
First Line : 2859 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4456
Country : US
Telephone Number : 773-522-2900
Fax Number : 773-522-3385
Authorized Official
Title or Position : PRESIDENT
Name : NARENDRA DESAI
Credential : RPH
Telephone Number : 773-522-2900
Provider Enumeration Date : 02/15/2007
Last Update Date : 12/05/2016

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Directions to “DESAI PHARMACY INC ” Practice Location

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