Provider Demographics
NPI:1932265907
Name:COMMUNITY PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:COMMUNITY PHARMACY SERVICES INC
Other - Org Name:COMMUNITY PHARMACY SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-262-4140
Mailing Address - Street 1:1555 W HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1555 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1707
Practice Address - Country:US
Practice Address - Phone:773-262-4140
Practice Address - Fax:773-262-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X
IL0540148393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1481718OtherNCPDP PROVIDER IDENTIFICATION NUMBER