Organization
PILL SHOP PHARMACY INC
Active
Other names
Pill Shop Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINE MOURANI (DIRECTOR)
(312) 659-3588
Entity
Organization
Contact information
Practice address
3535 E NEW YORK ST STE 117, AURORA, IL 60504-4466
(630) 618-2048
(630) 618-2394
Mailing address
3535 E NEW YORK ST STE 117, AURORA, IL 60504-4466
(630) 618-2048
(630) 618-2394
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.018224
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487873001
—
IL
01
—
2139415
PK
—
Enumeration date
03/18/2013
Last updated
05/18/2015
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