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Organization
MEDCENTRIX INC.
Active
Organization
MEDCENTRIX INC.
Active
Other names
Ingalls Pro Pharm ll
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD J. RUTKOWSKI (PHARMACY MANAGER)
(708) 915-7550
Entity
Organization
Contact information
Practice address
6701 159TH ST, TINLEY PARK, IL 60477-1758
(708) 915-7550
(708) 915-7507
Mailing address
6701 159TH ST, TINLEY PARK, IL 60477-1758
(708) 915-7550
(708) 915-7507
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054015155
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363374008002
—
IL
Enumeration date
04/25/2008
Last updated
04/25/2008
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