Organization
SJA PHARMACY, INC
Active
Other names
Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHITAL MANEK (PRESIDENT)
(630) 777-7800
Entity
Organization
Contact information
Practice address
9718 S HALSTED ST, CHICAGO, IL 60628-1007
(773) 238-4500
(773) 238-4503
Mailing address
9718 S HALSTED ST, CHICAGO, IL 60628-1007
(773) 238-4500
(773) 238-4503
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-018024
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487429
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2012
Last updated
10/23/2012
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