Provider Demographics
NPI:1982912085
Name:MAX CARE PHARMACY INC
Entity Type:Organization
Organization Name:MAX CARE PHARMACY INC
Other - Org Name:MAX CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:773-225-7666
Mailing Address - Street 1:2810 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1502
Mailing Address - Country:US
Mailing Address - Phone:773-508-9999
Mailing Address - Fax:773-508-9990
Practice Address - Street 1:2810 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1502
Practice Address - Country:US
Practice Address - Phone:773-508-9999
Practice Address - Fax:773-508-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
IL0540175493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2126929OtherPK
1484803OtherNCPDP PROVIDER IDENTIFICATION NUMBER