Provider Demographics
NPI:1942301932
Name:S AND R DRUGS INC / DBA: SEARS PHARMACY
Entity Type:Organization
Organization Name:S AND R DRUGS INC / DBA: SEARS PHARMACY
Other - Org Name:SEARS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATARIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:708-386-6304
Mailing Address - Street 1:1003 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4404
Mailing Address - Country:US
Mailing Address - Phone:708-386-6304
Mailing Address - Fax:708-386-6328
Practice Address - Street 1:1003 MADISON ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4404
Practice Address - Country:US
Practice Address - Phone:708-848-9050
Practice Address - Fax:708-386-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid
IL=========Medicaid