Organization
JW PHARMACY & DME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAFA DAKI PHARM.D. (CHIEF PHARMACIST)
(708) 588-0300
Entity
Organization
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 588-0300
(708) 588-0302
Mailing address
PO BOX 744, LA GRANGE, IL 60525-0744
(708) 588-0300
(708) 588-0302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054015550
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477911
NCPDP NUMBER
IL
Enumeration date
07/12/2006
Last updated
03/07/2023
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