Provena Pharmacy Elgin

LBN: Provena Pharmacy Elgin
Provena Pharmacy Elgin is an health care organization with primary practice located at 750 Fletcher Dr Ste 103, Elgin IL 60123-4703. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Provena Pharmacy Elgin can be contacted via phone (847) 931-5535, or through Rao, Satya via phone (847) 695-3200.

Contact Information

Primary practice address
750 Fletcher Dr Ste 103 Elgin IL 60123-4703
Phone: (847) 931-5535
Fax: (849) 622-2072
Website:
Map and Directions
Authorized official contact:
Name: Rao, Satya RPH
Phone: (847) 695-3200

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Clinic Pharmacy 3336C0002X 54013758 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1811902455
LBN Legal business name Provena Pharmacy Elgin
DBA Doing business as
Authorized official Rao, Satya RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1811902455 NPPES
Other 1460803 OTHER ID NUMBER-COMMERCIAL NUMBER

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