Organization
MEDCENTRIX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY NEISWONGER (INTERIM PRESIDENT)
(708) 915-6111
Entity
Organization
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 834-5601
(773) 702-6631
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 834-5601
(773) 702-6631
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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