Provider Demographics
NPI:1770019861
Name:SURECARE DISCOUNT INC
Entity Type:Organization
Organization Name:SURECARE DISCOUNT INC
Other - Org Name:MYCARE 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:T
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:773-649-1914
Mailing Address - Street 1:9718 S HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-1007
Mailing Address - Country:US
Mailing Address - Phone:773-649-1914
Mailing Address - Fax:773-830-1913
Practice Address - Street 1:9718 S HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-1007
Practice Address - Country:US
Practice Address - Phone:773-649-1914
Practice Address - Fax:773-830-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy