Petersons Prescription Pharmacy
LBN: Petersons Perscription Pharmacy Inc
Petersons Prescription Pharmacy is an health care organization with primary practice located at 715 Lake St , Oak Park IL 60301-1467. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Petersons Perscription Pharmacy Inc can be contacted via phone (708) 848-5020, or through Elich, William via phone (708) 868-5020.
Contact Information
Primary practice address
715 Lake St
Oak Park IL 60301-1467
Phone: (708) 848-5020
Fax: (708) 848-5022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054010011 | Illinois |
Profile Details
| NPI number | 1053322552 |
|---|---|
| LBN Legal business name | Petersons Perscription Pharmacy Inc |
| DBA Doing business as | Petersons Prescription Pharmacy |
| Authorized official | Elich, William RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Aug 31st, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053322552 | NPPES |
| Illinois | MEDICAID | 367728439001 | |
| Illinois | Other | 1459800 |
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