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AVICENNA PHARMACY INC NPI 1437420460


NPI Information

NPI: 1437420460
Provider Name: AVICENNA PHARMACY INC

Doing Business As: AVICENNA PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
10837 S CICERO AVE STE 110C
OAK LAWN, IL
ZIP 60453
Phone: (708) 529-7222
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AVICENNA PHARMACY INC is a community/retail pharmacy pharmacy in Oak Lawn, IL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. AVICENNA PHARMACY INC NPI is 1437420460. The provider is registered as an organization entity type.
The provider Is Doing Business As Avicenna Pharmacy.

The provider's business location address is:

10837 S CICERO AVE STE 110C
OAK LAWN, IL
ZIP 60453-459
Phone: (708) 529-7222
Fax: (708) 529-7325

The provider's authorized official is Ahmed Mahafzah .
The authorized official title is Owner, Pic, Ao and has the following contact phone number (708) 529-7222.

The enumeration date for this NPI number is 1/23/2012 and was last updated on 8/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0004XPharmacyCompounding PharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy054017745ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12133562OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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