Provider Demographics
NPI:1891807731
Name:FARMACIA CUATRO INC
Entity Type:Organization
Organization Name:FARMACIA CUATRO INC
Other - Org Name:FARMACIA CUATRO INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:EINBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-252-6003
Mailing Address - Street 1:4937 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-2505
Mailing Address - Country:US
Mailing Address - Phone:773-637-8010
Mailing Address - Fax:773-637-8033
Practice Address - Street 1:4937 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-2505
Practice Address - Country:US
Practice Address - Phone:773-637-8010
Practice Address - Fax:773-637-8033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
IL054146523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2021041OtherPK
2021041OtherPK