Provider Demographics
NPI:1356479075
Name:UFCW LOCAL 1546 HEALTH & WELFARE FUND
Entity Type:Organization
Organization Name:UFCW LOCAL 1546 HEALTH & WELFARE FUND
Other - Org Name:UMC PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-829-0850
Mailing Address - Street 1:1649 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3294
Mailing Address - Country:US
Mailing Address - Phone:312-829-1134
Mailing Address - Fax:
Practice Address - Street 1:1649 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3294
Practice Address - Country:US
Practice Address - Phone:312-829-1134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054014722333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy