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Organization
LIFECARE PHARMACY
Active
Organization
LIFECARE PHARMACY
Active
Other names
LIFECARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALTAMASH KHAN (MANAGER)
(224) 619-9786
Entity
Organization
Contact information
Practice address
276 W FULLERTON AVE, ADDISON, IL 60101-3767
(630) 543-1000
(630) 543-1002
Mailing address
276 W FULLERTON AVE, ADDISON, IL 60101-3767
(630) 543-1000
(630) 543-1002
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054.019534
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154865
PK
—
Enumeration date
10/22/2015
Last updated
02/20/2017
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