Edison Medical Pharmacy

LBN: Edison Medical Pharmacy Inc
Edison Medical Pharmacy is an health care organization with primary practice located at 4240 W Madison St , Chicago IL 60624-2288. 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. Edison Medical Pharmacy Inc can be contacted via phone (773) 533-2535, or through Shah, Pravinchandra via phone (773) 533-2535.

Contact Information

Primary practice address
4240 W Madison St Chicago IL 60624-2288
Phone: (773) 533-2535
Fax: (773) 533-2535
Website:
Map and Directions
Authorized official contact:
Name: Shah, Pravinchandra RPH
Phone: (773) 533-2535

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 054009337 Illinois

Profile Details

NPI number 1821166067
LBN Legal business name Edison Medical Pharmacy Inc
DBA Doing business as Edison Medical Pharmacy
Authorized official Shah, Pravinchandra RPH
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2006
Last updated Mar 13th, 2015 - about 10 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 1821166067 NPPES
Other 2020547 PK

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