Organization Name: | MARENGO COMMUNITY PHARMACY INC |
NPI Number: | 1114282266 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VIPUL PATEL (PRESIDENT/OWNER) |
Mailing Address: | 308 S State St Marengo |
State: | IL US |
Postal Code: | 601523532 |
Phone Number: | 8155687866 |
Fax Number: | 8155687867 |
NPI Enumeration Date: | 07/05/2012 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |