Organization
KEDZIE DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMLESH SHAH (PHARMACIST IN CHARGE)
(773) 826-4400
Entity
Organization
Contact information
Practice address
262 N KEDZIE AVE, CHICAGO, IL 60612-1869
(773) 826-4400
(773) 826-4400
Mailing address
262 N KEDZIE AVE, CHICAGO, IL 60612-1869
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1459305
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/15/2007
Last updated
04/20/2008
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