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NPI Code Detail

MEDICARE: BASINGERS PHARMACY INC

MEDICARE: BASINGERS 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
13336C0003XCommunity/Retail Pharmacy
23336C0002XClinic Pharmacy54017997IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12023753OTHERPK

General Provider Information

NPI Number : 1932281722
Entity Type Code : Organization
Provider Name (Legal Business Name) : BASINGERS PHARMACY INC
Provider Business Mailing Address
First Line : 300 N OTTAWA ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-4009
Country : US
Telephone Number : 815-722-3200
Fax Number : 815-722-3217
Provider Business Practice Location Address
First Line : 300 N OTTAWA ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-4009
Country : US
Telephone Number : 815-722-3200
Fax Number : 815-722-3217
Authorized Official
Title or Position : PRESIDENT
Name : HARISH BHATT
Credential :
Telephone Number : 815-725-1102
Provider Enumeration Date : 10/20/2006
Last Update Date : 11/07/2022

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