Organization
AMERICAN DRUG STORES LLC
Active
Other names
OSCO DRUG #1256
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
107 S RANDALL RD, ALGONQUIN, IL 60102
(847) 854-0242
(847) 854-5302
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-011513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022227
PK
—
Enumeration date
05/26/2006
Last updated
03/04/2020
Update your record
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