Organization
DRUGSTORE MAX LLC
Active
Other names
DRUGSTORE MAX LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TALITHA BANGALAN RPH (CEO)
(847) 501-0926
Entity
Organization
Contact information
Practice address
9228 INDIANAPOLIS BLVD, 7C, HIGHLAND, IN 46322-2558
(219) 595-0437
(219) 595-0169
Mailing address
9228 INDIANAPOLIS BLVD, 7C, HIGHLAND, IN 46322-2558
(219) 595-0437
(219) 595-0169
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054016432
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1562013
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/14/2008
Last updated
05/12/2010
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