Provider Demographics
NPI:1659068468
Name:MED USA PHARMACY INC
Entity Type:Organization
Organization Name:MED USA PHARMACY INC
Other - Org Name:MED USA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPLAVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:847-220-8558
Mailing Address - Street 1:333 E IL ROUTE 83 STE 100A
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4278
Mailing Address - Country:US
Mailing Address - Phone:847-220-8558
Mailing Address - Fax:224-475-0139
Practice Address - Street 1:333 E IL ROUTE 83 STE 100A
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4278
Practice Address - Country:US
Practice Address - Phone:847-220-8558
Practice Address - Fax:224-475-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy