Organization
CLARK PHARMACY INC
Active
Other names
Fullerton Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
IL HWANG PHARMD (PRESIDENT)
(773) 887-4052
Entity
Organization
Contact information
Practice address
5305 W FULLERTON AVE, CHICAGO, IL 60639-1424
(773) 877-4052
Mailing address
5305 W FULLERTON AVE, CHICAGO, IL 60639-1424
(773) 877-4052
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054.018328
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Enumeration date
09/12/2013
Last updated
05/05/2014
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