Provider Demographics
NPI:1376991851
Name:SUPER CARE PHARMACY, INC
Entity Type:Organization
Organization Name:SUPER CARE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAWAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-983-8856
Mailing Address - Street 1:8305 SKOKIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2546
Mailing Address - Country:US
Mailing Address - Phone:847-983-8856
Mailing Address - Fax:
Practice Address - Street 1:8305 SKOKIE BLVD.
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2546
Practice Address - Country:US
Practice Address - Phone:847-983-8856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.0195853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy