Organization
HEALTH SOURCE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET OVIEDO (OWNER)
(773) 683-4402
Entity
Organization
Contact information
Practice address
6723 CERMAK RD, BERWYN, IL 60402-2216
(773) 683-4402
Mailing address
6723 CERMAK RD, BERWYN, IL 60402-2216
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018075
IL
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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