Provider Demographics
NPI:1992004766
Name:HIGHLAND PHARMACY INC
Entity Type:Organization
Organization Name:HIGHLAND PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ABDUL
Authorized Official - Last Name:BAQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-844-1100
Mailing Address - Street 1:1177 N. HIGHLAND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506
Mailing Address - Country:US
Mailing Address - Phone:630-844-1100
Mailing Address - Fax:630-844-1101
Practice Address - Street 1:1177 N. HIGHLAND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506
Practice Address - Country:US
Practice Address - Phone:630-844-1100
Practice Address - Fax:630-844-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-19
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL05417611333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05417611OtherPHARMACY NUMBER