Provider Demographics
NPI:1922398791
Name:ALLCARE DISCOUNT PHARMACY INC
Entity Type:Organization
Organization Name:ALLCARE DISCOUNT PHARMACY INC
Other - Org Name:ALLCARE DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-432-4510
Mailing Address - Street 1:2750 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5247
Mailing Address - Country:US
Mailing Address - Phone:312-432-4510
Mailing Address - Fax:
Practice Address - Street 1:2750 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5247
Practice Address - Country:US
Practice Address - Phone:312-432-4510
Practice Address - Fax:773-278-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0002X, 3336I0012X, 3336M0002X
IL054.0176543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1485502OtherNCPDP PROVIDER IDENTIFICATION NUMBER