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Organization

LIFELINE PHARMACY, INC

Active
Other names
Lifeline Pharmacy, Inc
Organization subpart
No

Provider details

NPI number
Authorized official
SHITAL MANEK (OWNER)
(630) 777-7800
Entity
Organization

Contact information

Practice address
455 E MAIN ST STE 4, EAST DUNDEE, IL 60118-1523
(847) 450-0900
(847) 450-0920
Mailing address
455 E MAIN ST STE 4, EAST DUNDEE, IL 60118-1523
(847) 450-0900
(847) 450-0920

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
Primary
054020245
IL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2169083
PK
Enumeration date
05/01/2017
Last updated
05/01/2017
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