Organization
DENRICH CORP
Active
Other names
WESTMONT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS JORDAN (PRESIDENT, RESIDENT PHARMACIST)
(630) 969-2043
Entity
Organization
Contact information
Practice address
2 N CASS AVE, WESTMONT, IL 60559-1602
(630) 969-2043
(630) 969-2271
Mailing address
2 N CASS AVE, WESTMONT, IL 60559-1602
(630) 969-2043
(630) 969-2271
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054004627
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1428374
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/20/2006
Last updated
12/24/2009
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