American Drug Stores LLC
Pharmacy, Community/Retail Pharmacy in Burbank, IL. Organization (NPI-2).
NPI number1689620114
StatusActive
Last updated in NPPESJun 27, 2018
Details
- NPI
- 1689620114
- Entity type
- Organization (NPI-2)
- Legal business name
- American Drug Stores LLC
- Organization subpart
- No
- Enumeration date
- May 26, 2006
- Last updated
- Jun 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 054-013263 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Osco Drug #4060 (Doing Business As)
Practice location
7910 S Cicero AveBurbank, IL 60459
Phone 708-423-2098 · Fax 708-423-2582
Mailing address
250 E Parkcenter BlvdMailstop Sec2-B
Boise, ID 83706-3940
Authorized official
Tiffany Eliopulos
Enrollment Assistant Manager
2083953906
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