Provider Demographics
NPI:1952745937
Name:MERCY COMMUNITY PHARMACY AT OAKWOOD SHORES
Entity Type:Organization
Organization Name:MERCY COMMUNITY PHARMACY AT OAKWOOD SHORES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-567-5593
Mailing Address - Street 1:3753 S. COTTAGE GROVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653
Mailing Address - Country:US
Mailing Address - Phone:312-567-2489
Mailing Address - Fax:
Practice Address - Street 1:3753 S. COTTAGE GROVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653
Practice Address - Country:US
Practice Address - Phone:312-567-2489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOSPITAL & MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-22
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy