Organization
UKRIANIAN VILLAGE PHARMACY, INC.
Active
Other names
PharmaLife Chicago
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BOGACHEK (GENERAL MANAGER)
(404) 261-7775
Entity
Organization
Contact information
Practice address
2317 W CHICAGO AVE, CHICAGO, IL 60622-4723
(773) 235-5330
(773) 235-2674
Mailing address
2317 W CHICAGO AVE, CHICAGO, IL 60622-4723
(773) 235-5330
(773) 235-2674
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054015283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477505
NCPDP
IL
Enumeration date
06/11/2006
Last updated
08/17/2018
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