Organization Name: | BLUE ISLAND PHARMACY |
NPI Number: | 1154481588 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT L BLAESING (PRESIDENT) |
Mailing Address: | 17495 S La Grange Road Tinley Park |
State: | IL US |
Postal Code: | 60487 |
Phone Number: | 7082267100 |
Fax Number: | 7082267178 |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 0054014215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |