Organization
APOTHECO PHARMACY DECATUR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANUSH AMIN (PRESIDENT)
(973) 869-2820
Entity
Organization
Contact information
Practice address
17680 KEDZIE AVE, SUITE 104, HAZEL CREST, IL 60429
(708) 957-4949
(708) 957-4968
Mailing address
788 MORRIS TPKE, SUITE 300, SHORT HILLS, NJ 07078
(973) 869-2820
(973) 369-2822
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1459052
NABP NUMBER
IL
05
—
364403357001
—
IL
05
—
=========
—
IL
Enumeration date
11/17/2006
Last updated
05/30/2025
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