MEDICARE: PALCARE 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	054.017903	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2134885	OTHER		PK

General Provider Information

NPI Number	:	1790041564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALCARE INC

Provider Business Mailing Address
First Line	:	1848 S BLUE ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3013
Country	:	US
Telephone Number	:	312-465-2999
Fax Number	:	312-291-8079

Provider Business Practice Location Address
First Line	:	1848 S BLUE ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3013
Country	:	US
Telephone Number	:	312-465-2999
Fax Number	:	312-291-8079

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAWAD HAMDAN
Credential	:
Telephone Number	:	312-465-2999

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	06/28/2016

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Directions to “PALCARE INC ” Practice Location

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