Provider Demographics
NPI:1205036688
Name:CALS MEDICAL ENTERPRISES S C
Entity Type:Organization
Organization Name:CALS MEDICAL ENTERPRISES S C
Other - Org Name:CALS MEDICAL ENTERPRISES SC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANG
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-333-6660
Mailing Address - Street 1:83 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2347
Mailing Address - Country:US
Mailing Address - Phone:708-333-6660
Mailing Address - Fax:847-813-5135
Practice Address - Street 1:83 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2347
Practice Address - Country:US
Practice Address - Phone:708-333-6660
Practice Address - Fax:847-813-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336S0011X
IL0540163353336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2023626OtherPK
2023626OtherPK