Provider Demographics
NPI:1740389527
Name:SIMAR INC.
Entity Type:Organization
Organization Name:SIMAR INC.
Other - Org Name:ROCHELLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RUPESH
Authorized Official - Middle Name:BHARAT
Authorized Official - Last Name:MANEK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:815-562-4444
Mailing Address - Street 1:314 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068-1638
Mailing Address - Country:US
Mailing Address - Phone:815-562-4444
Mailing Address - Fax:
Practice Address - Street 1:314 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-1638
Practice Address - Country:US
Practice Address - Phone:815-562-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540144103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4004240001Medicare NSC