Provider Demographics
NPI:1427190966
Name:HEIGHTS PHARMACY, INC.
Entity Type:Organization
Organization Name:HEIGHTS PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCKSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:708-748-2630
Mailing Address - Street 1:2555 LINCOLN HWY
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1936
Mailing Address - Country:US
Mailing Address - Phone:708-748-2630
Mailing Address - Fax:708-748-2640
Practice Address - Street 1:2555 LINCOLN HWY
Practice Address - Street 2:SUITE 204A
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1936
Practice Address - Country:US
Practice Address - Phone:708-748-2630
Practice Address - Fax:708-748-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051030290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1462097OtherNCPDP
IL0514490001Medicare NSC