1918 Winter Street Operating Co LLC
Pharmacy, Community/Retail Pharmacy in Lombard, IL. Organization (NPI-2).
NPI number1033967815
StatusActive
Last updated in NPPESJul 24, 2024
Details
- NPI
- 1033967815
- Entity type
- Organization (NPI-2)
- Legal business name
- 1918 Winter Street Operating Co LLC
- Organization subpart
- No
- Enumeration date
- May 8, 2024
- Certification date
- May 1, 2024
- Last updated
- Jul 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Mariano'S Pharmacy #0543 (Doing Business As)
Practice location
345 W Roosevelt RdLombard, IL 60148-4219
Phone 630-629-4475 · Fax 630-629-4517
Mailing address
7 Corporate DrKeene, NH 03431-5042
Phone 603-354-7000
Authorized official
Kevin Mcnamara
Authorized Person
6033544619
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