Organization
AMERICAN DRUG STORES LLC
Active
Other names
OSCO DRUG #3443
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
5345 N BROADWAY ST, CHICAGO, IL 60640
(773) 334-2083
(773) 334-8829
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-006137
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017202
PK
—
Enumeration date
05/25/2006
Last updated
08/21/2025
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