Provider Demographics
NPI:1902444920
Name:PREFERRED PRESCRIPTIONS PHARMACY LLC
Entity Type:Organization
Organization Name:PREFERRED PRESCRIPTIONS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FEDJA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:618-508-4647
Mailing Address - Street 1:712 N DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3846
Mailing Address - Country:US
Mailing Address - Phone:618-508-4647
Mailing Address - Fax:312-508-4647
Practice Address - Street 1:1281 N FARNSWORTH AVE STE 1A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-2445
Practice Address - Country:US
Practice Address - Phone:618-508-4647
Practice Address - Fax:618-508-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy