Organization
87TH & HARLEM CRESCENT PHARMACY INC
Active
Other names
CRESCENT PHARMACY, Crescent Pharmacy In Bridgeview
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD TAHA (PIC)
(708) 598-0505
Entity
Organization
Contact information
Practice address
7261 W 87TH ST, BRIDGEVIEW, IL 60455-1821
(708) 598-0505
(708) 598-0606
Mailing address
7261 W 87TH ST, BRIDGEVIEW, IL 60455-1821
(708) 598-0505
(708) 598-0606
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054016428
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1481883
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
262023011001
—
IL
Enumeration date
04/22/2008
Last updated
07/11/2024
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