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MARTIN AVENUE PHARMACY INC NPI 1609806983


NPI Information

NPI: 1609806983
Provider Name: MARTIN AVENUE PHARMACY INC

Doing Business As: MARTIN AVENUE PHARMACY INC

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
1247 RICKERT DR
STE 100
NAPERVILLE, IL
ZIP 60540
Phone: (630) 355-6400
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MARTIN AVENUE PHARMACY INC is a community/retail pharmacy pharmacy in Naperville, 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. MARTIN AVENUE PHARMACY INC NPI is 1609806983. The provider is registered as an organization entity type.
The provider Is Doing Business As Martin Avenue Pharmacy Inc.

The provider's business location address is:

1247 RICKERT DR
STE 100
NAPERVILLE, IL
ZIP 60540-008
Phone: (630) 355-6400
Fax: (630) 355-6522

The provider's authorized official is Thomas Marks .
The authorized official title is President and has the following contact phone number (630) 355-6400.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 7/11/2016.


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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
43336C0003XPharmacyCommunity/Retail Pharmacy054004976ILLINOISYes

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
1=========001MEDICAIDILLINOIS
22022622OTHERPK

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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