<Unavail>

LBN: Petersons Perscription Pharmacy Inc
<Unavail> 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:
Map and Directions
Authorized official contact:
Name: Elich, William RPH
Phone: (708) 868-5020

Health care specialties

SpecialtyCodeLicense #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 <Unavail>
Authorized official Elich, William RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Aug 31st, 2012 - about 14 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 1053322552 NPPES
Illinois MEDICAID 367728439001
Illinois Other 1459800

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