# MEDCENTRIX INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ingalls Pro Pharm ll
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487829990
- **Authorized official:** MR. RONALD J. RUTKOWSKI (PHARMACY MANAGER)
- **Authorized official phone:** (708) 915-7550

## Contact information

- **Practice address:** 6701 159TH ST, TINLEY PARK, IL 60477-1758
- **Practice address phone:** (708) 915-7550
- **Practice address fax:** (708) 915-7507
- **Mailing address:** 6701 159TH ST, TINLEY PARK, IL 60477-1758
- **Mailing address phone:** (708) 915-7550
- **Mailing address fax:** (708) 915-7507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054015155 | IL | Yes |

## Other

- **Enumeration date:** 04/25/2008
- **Last updated:** 04/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 363374008002 | — | IL |