Organization Name: | TINLEY PARK PHARMACY, INC |
NPI Number: | 1780066456 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY HADDADIN (OWNER) |
Mailing Address: | 18210 S. Lagrange Rd Suite 101 Tinley Park |
State: | IL US |
Postal Code: | 604877722 |
Phone Number: | 7089957290 |
Fax Number: | 7089957371 |
NPI Enumeration Date: | 06/18/2015 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 054.019388 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
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 |