Organization
AMERICAN DRUG STORES LLC
Active
Other names
OSCO DRUG #2702
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENT)
(208) 395-3906
Entity
Organization
Contact information
Practice address
234 E VETERANS PKWY, YORKVILLE, IL 60560
(630) 553-8615
(630) 553-7842
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-014774
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021193
PK
—
Enumeration date
05/25/2006
Last updated
07/09/2018
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