Organization
GRANVILLE MEDICAL PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT S. JOSEPH RPH. (PRESIDENT/PHARMACIST)
(847) 729-9034
Entity
Organization
Contact information
Practice address
6212 N BROADWAY ST, CHICAGO, IL 60660-1903
(773) 274-5888
(773) 274-5961
Mailing address
6212 N BROADWAY ST, CHICAGO, IL 60660-1903
(773) 274-5888
(773) 274-5961
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1438387
NAPB
IL
Enumeration date
05/15/2006
Last updated
08/22/2020
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