MEDICARE: ALINA RX 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	054.018190	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2140381	OTHER		PK

General Provider Information

NPI Number	:	1508096488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALINA RX INC

Provider Business Mailing Address
First Line	:	1547 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5237
Country	:	US
Telephone Number	:	312-733-8662
Fax Number	:	312-733-8669

Provider Business Practice Location Address
First Line	:	1547 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5237
Country	:	US
Telephone Number	:	312-733-8662
Fax Number	:	312-733-8669

Authorized Official
Title or Position	:	PRESIDENT, OWNER
Name	:	MUHAMMAD RAMZAN
Credential	:
Telephone Number	:	312-733-8665

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	11/25/2015

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