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Organization
AVICENNA PHARMACY INC
Active
Organization
AVICENNA PHARMACY INC
Active
Other names
Avicenna Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED MAHAFZAH PHARM.D (PHARMACIST IN CHARGE)
(708) 529-7222
Entity
Organization
Contact information
Practice address
10837 S CICERO AVE STE 110C, OAK LAWN, IL 60453-6459
(708) 529-7222
(708) 529-7325
Mailing address
10604 SOUTHWEST HWY STE 102, CHICAGO RIDGE, IL 60415-2704
(708) 930-5393
(708) 529-3593
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
08/30/2023
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