Provider Demographics
NPI:1902972003
Name:NORTH STAR PHARMACY INC
Entity Type:Organization
Organization Name:NORTH STAR PHARMACY INC
Other - Org Name:ROSENBLUM DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN PHARMACY
Authorized Official - Phone:773-493-7733
Mailing Address - Street 1:2123 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-2103
Mailing Address - Country:US
Mailing Address - Phone:773-493-7733
Mailing Address - Fax:773-493-7734
Practice Address - Street 1:2123 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2103
Practice Address - Country:US
Practice Address - Phone:773-493-7733
Practice Address - Fax:773-493-7734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL0540098013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2020280OtherPK
2020280OtherPK
2020280OtherPK