Organization
MIDWEST SPECIALTY PHARMACY LLC
Active
Other names
Midwest Specialty Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
FEDJA TEMIM (DIRECTOR)
(312) 690-4585
Entity
Organization
Contact information
Practice address
712 N DEARBORN ST, STE. 3A, CHICAGO, IL 60654-3846
(312) 690-4585
(312) 690-4575
Mailing address
712 N DEARBORN ST, STE. 3A, CHICAGO, IL 60654-3846
(312) 690-4585
(312) 690-4575
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054020297
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168676
PK
—
Enumeration date
04/05/2017
Last updated
04/05/2017
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