Provider Demographics
NPI:1326144460
Name:ORLAND HILLS PHARMACY, INC.
Entity Type:Organization
Organization Name:ORLAND HILLS PHARMACY, INC.
Other - Org Name:HILLS DRUG ORLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUASTELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-226-9840
Mailing Address - Street 1:15300 WEST AVE
Mailing Address - Street 2:SUITE 123
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462
Mailing Address - Country:US
Mailing Address - Phone:708-226-9840
Mailing Address - Fax:708-226-9843
Practice Address - Street 1:15300 WEST AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462
Practice Address - Country:US
Practice Address - Phone:708-226-9840
Practice Address - Fax:708-226-9843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL54015253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1477074OtherNABP NO
IL1477074OtherNABP NO
IL5105400001Medicare ID - Type UnspecifiedMEDICARE NO