Organization
SHIVAADI CORPORATION
Active
Other names
BRIDGEPORT NEIGHBORHOOD PHARMACY, FCHC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIGNASA BHAVSAR (OWNER)
(773) 940-2000
Entity
Organization
Contact information
Practice address
3303 S HALSTED ST, CHICAGO, IL 60608-6877
(773) 940-2000
(773) 475-6732
Mailing address
3303 S HALSTED ST, CHICAGO, IL 60608-6877
(773) 940-2000
(773) 475-6732
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018936
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150552
PK
—
Enumeration date
01/29/2015
Last updated
02/10/2021
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