Organization
MASCOT PHARMACY INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA L COSTA RPH (OWNER PHARMACIST)
(847) 698-3323
Entity
Organization
Contact information
Practice address
110 MAIN ST, PARK RIDGE, IL 60068-4030
(847) 698-3323
(847) 698-4112
Mailing address
110 MAIN ST, PARK RIDGE, IL 60068-4030
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
054014403
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1425950
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/26/2006
Last updated
03/07/2023
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