Organization
AMALI, INC
Active
Other names
Roseland Pharmacy One
Organization subpart
No
Provider details
NPI number
Authorized official
FOUAD HALLAK (PRESIDENT)
(773) 660-8606
Entity
Organization
Contact information
Practice address
104 WEST 111TH STREET, CHICAGO, IL 60628
(773) 660-8606
Mailing address
104 WEST 111TH STREET, CHICAGO, IL 60628
(773) 660-8606
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054-016478
IL
Other
Enumeration date
12/14/2009
Last updated
12/14/2009
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