Organization
ADDISON PHARMACY & MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KERUL MEHTA RPH (PHARMACY MANAGER)
(630) 543-0988
Entity
Organization
Contact information
Practice address
441 W LAKE ST, ADDISON, IL 60101-2316
(630) 543-0988
(630) 543-0918
Mailing address
414 W LAKE ST, ADDISON, IL 60101-2305
(630) 543-0988
(630) 543-0918
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475791
NABP
IL
Enumeration date
08/12/2014
Last updated
01/12/2016
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