MEDICARE: PHARMCHEMETICS 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	054004378	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2022968	OTHER		PK

General Provider Information

NPI Number	:	1790859213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMCHEMETICS INC

Provider Business Mailing Address
First Line	:	1001 W LAWRENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5017
Country	:	US
Telephone Number	:	773-561-2288
Fax Number	:	773-561-5332

Provider Business Practice Location Address
First Line	:	1001 W LAWRENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5017
Country	:	US
Telephone Number	:	773-561-2288
Fax Number	:	773-561-5332

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEPH ROGOWIN
Credential	:	RPH
Telephone Number	:	773-561-2288

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	10/04/2017

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Directions to “PHARMCHEMETICS INC ” Practice Location

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