Organization
GSK PHARMACY INC
Active
Other names
GSK PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVIN KHATRI RPH (PRESIDENT)
(773) 287-1078
Entity
Organization
Contact information
Practice address
5140 W CHICAGO AVE, CHICAGO, IL 60651-2903
(773) 287-1078
(847) 699-9767
Mailing address
5140 W CHICAGO AVE, CHICAGO, IL 60651-2903
(773) 287-1078
(847) 699-9767
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.012049
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019825
PK
—
Enumeration date
12/13/2006
Last updated
11/09/2015
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