Whiting Community Pharmacy Inc
Organization Active NPI Pharmacy · Whiting, IN
NPI 1013688977 · NPPES record last updated Aug 17, 2022
Key facts
- NPI
- 1013688977
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- WHITING COMMUNITY PHARMACY INC
- Practice address
- 1236 119TH St
Whiting, IN 46394-1640 - Phone
- (773) 564-3669
- NPI assigned
- Sep 21, 2021
- Organization subpart
- No
Authorized official
- Name
- Amyra Muhammad, PHARMD
- Title
- Owner
- Phone
- (773) 564-3669
Practitioners 1
-
Amyra H Muhammad, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221026002836 | IN | Part B Supplier - Pharmacy | 1658756697 | Practice locations: Whiting, IN |
National Provider Directory
Locations
1236 119th St
Ste 1
Whiting, IN 46394
Phone (219) 655-5529
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
1236 119TH St
Whiting, IN 46394-1640
Mailing address
505 E Holly Ave
Mount Prospect, IL 60056-2139
Phone (773) 564-3669
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300060477 | Medicaid | IN |
Other providers in Whiting, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.