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Organization
AMERICAN DRUG STORES LLC
Active
Organization
AMERICAN DRUG STORES LLC
Active
Parent organization
SUPERVALU INC
Other names
OSCO DRUG
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPERVALU INC
Authorized official
DIONA TOWNSEND (ASST MGR PLAN IMPLEMENTATION)
(847) 916-4513
Entity
Organization
Contact information
Practice address
1414 N DIVISION ST, MORRIS, IL 60450-1583
(815) 941-2353
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476539
NCPDP PROVIDER NUMBER
—
Enumeration date
10/19/2011
Last updated
10/19/2011
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