Provider Demographics
NPI:1134567647
Name:SHAMROCK RX, INC.
Entity type:Organization
Organization Name:SHAMROCK RX, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:O'SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:855-895-7979
Mailing Address - Street 1:747 HERRA ST
Mailing Address - Street 2:UNIT E
Mailing Address - City:ELBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60119-8437
Mailing Address - Country:US
Mailing Address - Phone:855-895-7979
Mailing Address - Fax:855-742-7979
Practice Address - Street 1:747 HERRA ST
Practice Address - Street 2:UNIT E
Practice Address - City:ELBURN
Practice Address - State:IL
Practice Address - Zip Code:60119-8437
Practice Address - Country:US
Practice Address - Phone:855-895-7979
Practice Address - Fax:855-742-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0182383336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy