# APOTHECO PHARMACY DECATUR LLC

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

## Provider details

- **NPI number:** 1861565665
- **Authorized official:** ANUSH AMIN (PRESIDENT)
- **Authorized official phone:** (973) 869-2820

## Contact information

- **Practice address:** 17680 KEDZIE AVE, SUITE 104, HAZEL CREST, IL 60429
- **Practice address phone:** (708) 957-4949
- **Practice address fax:** (708) 957-4968
- **Mailing address:** 788 MORRIS TPKE, SUITE 300, SHORT HILLS, NJ 07078
- **Mailing address phone:** (973) 869-2820
- **Mailing address fax:** (973) 369-2822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 05/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1459052 | NABP NUMBER | IL |
| 05 | — | 364403357001 | — | IL |
| 05 | — | ========= | — | IL |