Organization
365RX LLC
Active
Other names
365RX LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY HERNANDEZ (INS. CONTRACTING RPRESENTATIVE)
(708) 375-5736
Entity
Organization
Contact information
Practice address
150 FENCL LN, HILLSIDE, IL 60162-2041
(708) 449-7600
(708) 375-5820
Mailing address
150 FENCL LN, HILLSIDE, IL 60162-2041
(708) 449-7600
(708) 375-5820
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150215
PK
—
Enumeration date
02/06/2015
Last updated
02/12/2015
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