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Organization
PHYSICIANS COMMUNITY PHARMACY, INC
Active
Organization
PHYSICIANS COMMUNITY PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD J MINGOLELLI MD (PRESIDENT)
(708) 798-8112
Entity
Organization
Contact information
Practice address
5320 159TH ST, SUITE 201, OAK FOREST, IL 60452-4705
(708) 798-8112
(708) 535-6396
Mailing address
5320 159TH ST, SUITE 400, OAK FOREST, IL 60452-4705
(708) 798-8112
(708) 535-6396
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
320009946
IL
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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