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PROVENA PHARMACY ELGIN NPI 1811902455


NPI Information

NPI: 1811902455
Provider Name: PROVENA PHARMACY ELGIN
Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
750 FLETCHER DR
STE 103
ELGIN, IL
ZIP 60123
Phone: (847) 931-5535
Get Directions

PROVENA PHARMACY ELGIN is a clinic pharmacy pharmacy in Elgin, IL. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. PROVENA PHARMACY ELGIN NPI is 1811902455. The provider is registered as an organization entity type.

The provider's business location address is:

750 FLETCHER DR
STE 103
ELGIN, IL
ZIP 60123-703
Phone: (847) 931-5535
Fax: (849) 622-2072

The provider's authorized official is Satya Rao .
The authorized official title is Dir Of Phcy and has the following contact phone number (847) 695-3200.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0002XPharmacyClinic Pharmacy54013758ILLINOISYes
23336C0003XPharmacyCommunity/Retail PharmacyX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11460803OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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