MEDICARE: AMERICAN 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
1	3336C0002X	Clinic Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy
5	3336C0004X	Compounding Pharmacy	51032572	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1463289	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1649270125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN PHARMACY INC

Provider Business Mailing Address
First Line	:	2200 W ROOSEVELT RD
Second Line	:
City	:	BROADVIEW
State	:	IL
Zip	:	60155-3888
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 W ROOSEVELT RD
Second Line	:
City	:	BROADVIEW
State	:	IL
Zip	:	60155-3888
Country	:	US
Telephone Number	:	708-343-5730
Fax Number	:	708-343-2130

Authorized Official
Title or Position	:	PIC
Name	:	KANAIYALAL VIRPARIA
Credential	:
Telephone Number	:	708-343-5780

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	04/20/2008

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Directions to “AMERICAN PHARMACY INC ” Practice Location

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