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Organization
UNION HEALTH SERVICE INC
Active
Organization
UNION HEALTH SERVICE INC
Active
Other names
Union Health Service, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON STULL BS PHARMACY (PHARMACY MANAGER)
(312) 423-4260
Entity
Organization
Contact information
Practice address
1634 W POLK ST, CHICAGO, IL 60612-4352
(312) 423-4260
(312) 423-4392
Mailing address
1634 W POLK ST, CHICAGO, IL 60612-4352
(312) 423-4260
(312) 423-4392
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336M0003X
Managed Care Organization Pharmacy
Primary
054017371
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022577
PK
—
Enumeration date
08/31/2006
Last updated
07/19/2018
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