Organization
LOYOLA UNIVERSITY MEDICAL CENTER
Active
Other names
MULCAHY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY GOLDBERG (PRESIDENT AND CEO)
(708) 216-0588
Entity
Organization
Contact information
Practice address
2160 S 1ST AVE, BLDG 107, MAYWOOD, IL 60153-3328
(708) 216-9100
(708) 216-1554
Mailing address
2160 S 1ST AVE, BLDG 107, MAYWOOD, IL 60153-3328
(708) 216-9100
(708) 216-1554
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054017263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2024686
PK
—
Enumeration date
12/27/2006
Last updated
01/13/2017
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