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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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