# SENIOR CARE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780858647
- **Authorized official:** JENIFER PENA (MANAGER)
- **Authorized official phone:** (847) 579-0093

## Contact information

- **Practice address:** 4043 MAIN ST, SKOKIE, IL 60076-2778
- **Practice address phone:** (847) 579-0093
- **Practice address fax:** (847) 983-4766
- **Mailing address:** 4043 MAIN ST, SKOKIE, IL 60076-2778
- **Mailing address phone:** (847) 579-0093
- **Mailing address fax:** (847) 983-4766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054016421 | IL | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 04/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2023668 | PK | — |