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Organization
JEAN PIERRE JEAN INC
Active
Organization
JEAN PIERRE JEAN INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELMA J JEAN (OWNER PHARMACIST)
(708) 957-6039
Entity
Organization
Contact information
Practice address
3015 W 183RD STREET, HOMEWOOD, IL 60430
(708) 957-6039
(708) 957-5073
Mailing address
3015 W 183RD STREET, HOMEWOOD, IL 60430
(708) 957-6039
(708) 957-5073
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
032005145
IL
333600000X
Pharmacy
054013140
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1147170001
MEDICARE NUMBER
—
01
—
1466590
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/05/2006
Last updated
04/20/2008
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