Provider Demographics
NPI:1497504617
Name:PROHEALTH PHARMACY LLC
Entity type:Organization
Organization Name:PROHEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:RUSHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-423-2242
Mailing Address - Street 1:4709 GOLF RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1238
Mailing Address - Country:US
Mailing Address - Phone:847-423-2242
Mailing Address - Fax:
Practice Address - Street 1:4709 GOLF RD STE 110
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1238
Practice Address - Country:US
Practice Address - Phone:847-423-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROHEALTH PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy