Provider Demographics
NPI:1962639765
Name:CAROL STREAM PHARMACY P.C
Entity Type:Organization
Organization Name:CAROL STREAM PHARMACY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BINH
Authorized Official - Middle Name:C
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:816-824-2024
Mailing Address - Street 1:620 E SAINT CHARLES RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2692
Mailing Address - Country:US
Mailing Address - Phone:630-868-3722
Mailing Address - Fax:
Practice Address - Street 1:620 E SAINT CHARLES RD
Practice Address - Street 2:UNIT B
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2692
Practice Address - Country:US
Practice Address - Phone:630-868-3722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy