Organization
AMERICAN DRUG STORES LLC
Active
Other names
OSCO DRUG #3495
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ENROLLMENT ASSISTANT MANAGER)
(208) 395-3906
Entity
Organization
Contact information
Practice address
1127 S YORK RD, BENSENVILLE, IL 60106
(630) 238-0289
(630) 238-0281
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(847) 916-4463
(847) 916-4736
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-019795
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154650
PK
—
Enumeration date
10/14/2015
Last updated
06/28/2018
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