Organization
CARTAGENA PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD KIELAR (PHARMACIST IN CHARGE)
(773) 274-7885
Entity
Organization
Contact information
Practice address
1505 W DEVON AVE, CHICAGO, IL 60660-1313
(773) 274-7885
(773) 274-7906
Mailing address
1505 W DEVON AVE, CHICAGO, IL 60660-1313
(773) 274-7885
(773) 274-7906
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
IL05411448
IL
3336M0003X
Managed Care Organization Pharmacy
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1463342
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
03/01/2007
Last updated
02/22/2011
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