Organization
OAK LAWN PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMA ALZEIN PHARM.D. (PRESIDENT)
(708) 955-4933
Entity
Organization
Contact information
Practice address
4700 W 95TH ST, SUITE 101, OAK LAWN, IL 60453-2533
(708) 424-0600
(708) 424-0615
Mailing address
4700 W 95TH ST, SUITE 101, OAK LAWN, IL 60453-2533
(708) 424-0600
(708) 424-0615
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
054-016816
IL
3336C0003X
Community/Retail Pharmacy
054-016816
IL
3336M0002X
Mail Order Pharmacy
054-016816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054-016816
PHARMACY
IL
Enumeration date
04/03/2010
Last updated
06/20/2012
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