Provider Demographics
NPI:1205937448
Name:S,K,PHARMACY INC
Entity type:Organization
Organization Name:S,K,PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:C
Authorized Official - Last Name:MANEK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:630-820-3360
Mailing Address - Street 1:475 N FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3004
Mailing Address - Country:US
Mailing Address - Phone:630-820-3360
Mailing Address - Fax:630-820-6864
Practice Address - Street 1:475 N FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3004
Practice Address - Country:US
Practice Address - Phone:630-820-3360
Practice Address - Fax:630-820-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0112903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid
IL1169550001Medicare NSC