Organization
MALL PHARMACY, INC
Active
Other names
Scripts Rx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT R CUNNINGHAM (PRESIDENT)
(800) 592-7174
Entity
Organization
Contact information
Practice address
1815 S MEYERS RD STE 100, OAKBROOK TERRACE, IL 60181-5226
(800) 592-7174
Mailing address
1815 S MEYERS RD STE 100, OAKBROOK TERRACE, IL 60181-5226
(800) 592-7174
(877) 992-3831
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054020079
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1468481
NCPDP
IL
Enumeration date
01/01/2007
Last updated
12/06/2021
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