Organization
BASINGERS LOCKPORT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARISH BHATT (OWNER AND PRESIDENT)
(815) 836-0500
Entity
Organization
Contact information
Practice address
500 SUMMIT DR, LOCKPORT, IL 60441-3392
(815) 836-0500
(815) 836-0180
Mailing address
500 SUMMIT DR, LOCKPORT, IL 60441-3392
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
54014892
IL
3336M0002X
Mail Order Pharmacy
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475830
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
04/20/2008
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