Organization
SIMPLY PURE RX INC
Active
Other names
Simply Pure Rx
Organization subpart
No
Provider details
NPI number
Authorized official
SAMI MUSLEH (CO-OWNER/CHIEF PHARMACIST)
(708) 227-0505
Entity
Organization
Contact information
Practice address
1607 BENSON AVE, EVANSTON, IL 60201-3717
(847) 227-8020
(847) 868-8426
Mailing address
1607 BENSON AVE, EVANSTON, IL 60201-3717
(847) 227-8020
(847) 868-8426
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054019323
IL
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157929
PK
—
Enumeration date
01/28/2016
Last updated
03/03/2016
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