Provider Demographics
NPI:1730303751
Name:PHARMA BIO INC
Entity Type:Organization
Organization Name:PHARMA BIO INC
Other - Org Name:PBI BILLING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:REILAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:708-339-6200
Mailing Address - Street 1:9700 WEST 197TH STREET
Mailing Address - Street 2:SUITE 106-4
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8944
Mailing Address - Country:US
Mailing Address - Phone:708-339-6200
Mailing Address - Fax:
Practice Address - Street 1:9700 197TH ST
Practice Address - Street 2:SUITE 106-4
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8944
Practice Address - Country:US
Practice Address - Phone:708-339-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMA BIO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-12
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL004-000558332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL361550Medicaid
IL094044001Medicare ID - Type UnspecifiedA