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NPI Code Detail

MEDICARE: AMBIKA PHARMACY, INC.

MEDICARE: AMBIKA 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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11448009OTHERNABP #

General Provider Information

NPI Number : 1639165475
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMBIKA PHARMACY, INC.
Provider Business Mailing Address
First Line : 11309 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60628-4911
Country : US
Telephone Number : 773-264-1111
Fax Number :
Provider Business Practice Location Address
First Line : 11309 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60628-4911
Country : US
Telephone Number : 773-264-1111
Fax Number :
Authorized Official
Title or Position : OWNER PRESIDENT
Name : MR. ILESH J SHAH
Credential : RPH
Telephone Number : 773-264-1111
Provider Enumeration Date : 09/27/2005
Last Update Date : 05/12/2008

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Directions to “AMBIKA PHARMACY, INC. ” Practice Location

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