Organization
WELLCARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANI ABDALLAH RPH (OWNER, AO, PHCY MANAGER, PIC)
(708) 307-7839
Entity
Organization
Contact information
Practice address
9760 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3109
(708) 930-5927
(708) 930-5935
Mailing address
9760 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3109
(708) 930-5927
(708) 930-5935
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054020144
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167135
PK
—
Enumeration date
12/22/2016
Last updated
03/23/2017
About Stedi
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