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Organization

AMERICAN DRUG STORES LLC

Active
Other names
OSCO DRUG #3459
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY ELIOPULOS (ENROLLMENT ASSISTANT MANAGER)
(208) 395-3906
Entity
Organization

Contact information

Practice address
1600 DEERFIELD RD, HIGHLAND PARK, IL 60035
(847) 579-0884
(847) 579-0895
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
054-001322
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2022365
PK
Enumeration date
05/25/2006
Last updated
06/28/2018
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