MEDICARE: SHARIF 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	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	054.012040	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2021699	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700973997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARIF PHARMACY INC

Provider Business Mailing Address
First Line	:	2004 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-3767
Country	:	US
Telephone Number	:	773-227-1211
Fax Number	:	773-227-3255

Provider Business Practice Location Address
First Line	:	2004 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-3767
Country	:	US
Telephone Number	:	773-227-1211
Fax Number	:	773-227-3255

Authorized Official
Title or Position	:	PHARMACY DIRECTOR
Name	:	RICHARD SHARIF
Credential	:
Telephone Number	:	773-227-1211

Provider Enumeration Date	:	10/07/2006
Last Update Date	:	12/18/2016

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Directions to “SHARIF PHARMACY INC ” Practice Location

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