Provider Demographics
NPI:1689138448
Name:SURECARE DISCOUNT PHARMACY 2 INC
Entity Type:Organization
Organization Name:SURECARE DISCOUNT PHARMACY 2 INC
Other - Org Name:FRIEND HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HANSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-666-8005
Mailing Address - Street 1:6250 S COTTAGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-2530
Mailing Address - Country:US
Mailing Address - Phone:708-666-8005
Mailing Address - Fax:708-666-8009
Practice Address - Street 1:6250 S COTTAGE GROVE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-2530
Practice Address - Country:US
Practice Address - Phone:708-666-8005
Practice Address - Fax:708-666-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy