Organization
LIFEMED ILLINOIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MAYA PHARM. D. (MANAGER)
(954) 385-4998
Entity
Organization
Contact information
Practice address
881 IL ROUTE 83, BENSENVILLE, IL 60106-1219
(888) 806-3379
(954) 385-4942
Mailing address
15491 SW 12TH ST, SUITE 400, SUNRISE, FL 33326-1991
(954) 385-4998
(954) 385-4942
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
IL
Other
Enumeration date
04/11/2014
Last updated
04/11/2014
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