Midc Pharmacy

NPI 1184610396 - Home Infusion - 251F00000X

NPI Details
NPI 1184610396
Enumeration Date 09/22/2005
Last Updated 07/08/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name RUSSELL MARTIN RUSSELL
Position MANAGING PARTNER
Phone (888) 220-6432
Fax (630) 734-4715
Practice Location
901 MCCLINTOCK DR
SUITE 202
BURR RIDGE IL, 60527-0844, US
Phone (888) 220-6432
Fax (630) 734-4715
Business Location
901 MCCLINTOCK DR
SUITE 202
BURR RIDGE IL, 60527-0844, US
Phone (888) 220-6432
Fax (630) 654-4253
Toxanomy
Taxonomy Code 251F00000X
License State Illinois
License Number 054-015148
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According to our database, Midc Pharmacy NPI is 1184610396, taxonomy code is 251F00000X and license number is 054-015148, license state is located at Illinois. Midc Pharmacy physically located at 901 Mcclintock Dr, Burr Ridge IL, 60527-0844. NPI Number 1033115704 has the healthcare provider type.

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1184610396 NPI number is provided on an as is basis without warranty of any kind. 1184610396 is maintained by the National Plan & Provider Enumeration System. The contents of Midc Pharmacy are for informational purposes only.