# KOZ-LAZ INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ARCHER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265544100
- **Authorized official:** JACK LAZZARA RPH (PRESIDENT AND OWNER)
- **Authorized official phone:** (773) 586-1134

## Contact information

- **Practice address:** 6456 W ARCHER AVE, CHICAGO, IL 60638-2537
- **Practice address phone:** (773) 586-1134
- **Practice address fax:** (773) 586-1151
- **Mailing address:** 6456 W ARCHER AVE, CHICAGO, IL 60638-2537
- **Mailing address phone:** (773) 586-1134
- **Mailing address fax:** (773) 586-1151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054013977 | IL | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 10/13/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1469368 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |