Provider Demographics
NPI:1043221542
Name:ELFMAN PHARMACY INC
Entity Type:Organization
Organization Name:ELFMAN PHARMACY INC
Other - Org Name:ELFMAN PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:EINBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-292-1030
Mailing Address - Street 1:3202 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4940
Mailing Address - Country:US
Mailing Address - Phone:773-292-1030
Mailing Address - Fax:773-292-1053
Practice Address - Street 1:3202 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4940
Practice Address - Country:US
Practice Address - Phone:773-292-1030
Practice Address - Fax:773-292-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL540143023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2025403OtherPK
IL=========001Medicaid
IL=========001Medicaid