Organization
SUZANNE PHARMACY INC.
Active
Other names
Crescent Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CAHGOYA (CORPORATE OFFICER)
(773) 847-6160
Entity
Organization
Contact information
Practice address
4647 W 103RD ST STE 1A, OAK LAWN, IL 60453-4792
(708) 774-9944
Mailing address
4647 W 103RD ST STE 1A, OAK LAWN, IL 60453-4792
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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