Organization
CORDANT PHARMACY ILLINOIS, LLC
Active
Parent organization
CORDANT PHARMACY ILLINOIS, LLC
Other names
Cordant Pharmacy Solutions #R118
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORDANT PHARMACY ILLINOIS, LLC
Authorized official
FARA TIPPIT (EXECUTIVE ASSISTANT)
(720) 272-3535
Entity
Organization
Contact information
Practice address
8623 W BRYN MAWR AVE STE 504, CHICAGO, IL 60631-3525
(872) 264-5673
Mailing address
1620 W NORTHWEST HWY STE 100, GRAPEVINE, TX 76051-3219
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054.021576
ILLINOIS BOARD OF PHARMACY
IL
Enumeration date
10/14/2020
Last updated
10/14/2020
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