Provider Demographics
NPI:1629127543
Name:ATREE INC
Entity Type:Organization
Organization Name:ATREE INC
Other - Org Name:HARVEY HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:R.PH IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MAHENDRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:708-225-1984
Mailing Address - Street 1:3530 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60428-4047
Mailing Address - Country:US
Mailing Address - Phone:708-225-1984
Mailing Address - Fax:
Practice Address - Street 1:3530 W 159TH ST
Practice Address - Street 2:
Practice Address - City:MARKHAM
Practice Address - State:IL
Practice Address - Zip Code:60428-4047
Practice Address - Country:US
Practice Address - Phone:708-225-1984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0133633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3925890001Medicare NSC