Organization
DEL LAGO PHARMACY LTD
Active
Other names
DEL LAGO PHARMACY LTD
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BOTHSCHILD RPH (SECRETARY)
(847) 256-3950
Entity
Organization
Contact information
Practice address
1515 SHERIDAN RD, WILMETTE, IL 60091-1882
(847) 256-3950
(847) 256-3957
Mailing address
1515 SHERIDAN RD, WILMETTE, IL 60091-1882
(847) 256-3950
(847) 256-3957
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054004961
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1430204
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
04/19/2011
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