# GOLF MILL PHARMACY AND MEDICAL SUPPLY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Golf Mill Pharmacy and Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144464876
- **Authorized official:** VLADIMIR DEYSKI PHARM. D. (PIC)
- **Authorized official phone:** (847) 803-3340

## Contact information

- **Practice address:** 8941 W GOLF RD, NILES, IL 60714-5812
- **Practice address phone:** (847) 803-3340
- **Practice address fax:** (847) 803-3342
- **Mailing address:** 8334 KARLOV AVE, SKOKIE, IL 60076-2738
- **Mailing address phone:** (847) 803-3340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054016631 | IL | Yes |

## Other

- **Enumeration date:** 04/24/2009
- **Last updated:** 04/15/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2119936 | PK | — |