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Organization
FOREST PARK PHARMACY INC
Active
Organization
FOREST PARK PHARMACY INC
Active
Other names
Forest Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMIRA JAHIC (VICE PRESIDENT)
(314) 645-9990
Entity
Organization
Contact information
Practice address
331 SALEM PL, FAIRVIEW HEIGHTS, IL 62208-1340
(618) 607-0200
(618) 607-0201
Mailing address
331 SALEM PL, FAIRVIEW HEIGHTS, IL 62208-1340
(618) 607-0200
(618) 607-0201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054020100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162590
PK
—
Enumeration date
09/01/2016
Last updated
01/18/2017
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