Provider Demographics
NPI:1790018075
Name:DME INC
Entity Type:Organization
Organization Name:DME INC
Other - Org Name:PILL BOX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:THANUGUNDLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-416-3800
Mailing Address - Street 1:6408 N NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1743
Mailing Address - Country:US
Mailing Address - Phone:773-416-3800
Mailing Address - Fax:773-728-6853
Practice Address - Street 1:7122 S VINCENNES AVE STE G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-3672
Practice Address - Country:US
Practice Address - Phone:773-488-1600
Practice Address - Fax:773-488-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.016714333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1483914OtherNCPDP PROVIDER IDENTIFICATION NUMBER