Organization
FOREST PARK PHARMACY INC
Active
Other names
Forest Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMIRA JAHIC (VICE PRESIDENT)
(314) 645-9990
Entity
Organization
Contact information
Practice address
331 SALEM PL, FAIRVIEW HEIGHTS, IL 62208-1340
(618) 607-0200
(618) 607-0201
Mailing address
331 SALEM PL, FAIRVIEW HEIGHTS, IL 62208-1340
(618) 607-0200
(618) 607-0201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054020100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162590
PK
—
Enumeration date
09/01/2016
Last updated
01/18/2017
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