Organization
METROPOLITIAN AUSTIN OUTPATIENT PHARMACY LLC
Active
Other names
Austin Outpatient Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMY ALEXANDER (CHIEF FINANCIAL OFFICER)
(516) 459-1577
Entity
Organization
Contact information
Practice address
645 S CENTRAL AVE STE 1, CHICAGO, IL 60644-5059
(773) 854-2500
(773) 854-2600
Mailing address
645 S CENTRAL AVE STE 1, CHICAGO, IL 60644-5059
(773) 854-2500
(773) 854-2600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054.021290
PHARMACY LICENSE NO.
IL
Enumeration date
03/02/2020
Last updated
03/07/2023
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