Pharmblue Illinois Llc

LBN: Pharmblue Illinois Llc
Pharmblue Illinois Llc is an health care organization with primary practice located at 2960 Chartres St Ste 100 , La Salle IL 61301-1097. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pharmblue Illinois Llc can be contacted via phone (724) 779-4720, or through Nelson, Mike via phone (724) 779-4720.

Contact Information

Primary practice address
2960 Chartres St Ste 100 La Salle IL 61301-1097
Phone: (724) 779-4720
Fax: (844) 873-8758
Website:
Map and Directions
Authorized official contact:
Name: Nelson, Mike
Phone: (724) 779-4720

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 265190 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X 054-019566 Illinois
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1699146720
LBN Legal business name Pharmblue Illinois Llc
DBA Doing business as Pharmblue Illinois Llc
Authorized official Nelson, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Oct 15th, 2015
Last updated Mar 24th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699146720 NPPES
Other 2154972 PK
MEDICAID 454805748001 PK

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