111Th Pharma Family

LBN: 111Th Pharma - Family
111Th Pharma Family is an health care organization with primary practice located at 11101 S State St , Chicago IL 60628-4206. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. 111Th Pharma - Family can be contacted via phone (773) 785-5192, or through Vanjackson, Adele via phone (773) 785-5192.

Contact Information

Primary practice address
11101 S State St Chicago IL 60628-4206
Phone: (773) 785-5192
Fax: (773) 821-6970
Website:
Map and Directions
Authorized official contact:
Name: Vanjackson, Adele
Phone: (773) 785-5192

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 054018137 Illinois

Profile Details

NPI number 1255415386
LBN Legal business name 111Th Pharma - Family
DBA Doing business as 111Th Pharma Family
Authorized official Vanjackson, Adele
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2006
Last updated Aug 27th, 2013 - about 13 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 1255415386 NPPES
Other 2141774 PK

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