Organization
BENZER IL 1 LLC
Active
Other names
Benzer Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
2024 W. 79TH STREET, CHICAGO, IL 60620
(773) 994-2845
(773) 482-2008
Mailing address
5908 BRECKENRIDGE PARKWAY, TAMPA, FL 33610
(813) 304-2221
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
054.009724
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017827
PK
—
05
—
364088230001
—
IL
Enumeration date
04/19/2007
Last updated
01/29/2019
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