Provider Demographics
NPI:1518232669
Name:PHARMA PLUS INC
Entity Type:Organization
Organization Name:PHARMA PLUS INC
Other - Org Name:DRUG CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-949-8150
Mailing Address - Street 1:10 ORLAND SQUARE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3207
Mailing Address - Country:US
Mailing Address - Phone:708-949-8150
Mailing Address - Fax:708-949-8047
Practice Address - Street 1:10 ORLAND SQUARE DR STE 102
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3207
Practice Address - Country:US
Practice Address - Phone:708-949-8150
Practice Address - Fax:708-949-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL054.0178823336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1486629OtherNCPDP PROVIDER IDENTIFICATION NUMBER