Provider Demographics
NPI:1669656856
Name:MASANGCAY, LADY AMABELLE A (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:LADY AMABELLE
Middle Name:A
Last Name:MASANGCAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:3531 N BROADWAY ST
Mailing Address - Street 2:OSCO PHARMACY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1825
Mailing Address - Country:US
Mailing Address - Phone:773-528-6615
Mailing Address - Fax:773-404-6916
Practice Address - Street 1:3531 N BROADWAY AVE
Practice Address - Street 2:OSCO PHARMACY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1825
Practice Address - Country:US
Practice Address - Phone:773-528-6615
Practice Address - Fax:773-404-6916
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist