NPIMap

Organization Active NPI

Mediderm Inc.

Doing business as MedidermRx

  • Community/Retail Pharmacy
  • Buffalo Grove, IL
National Provider Identifier
1033389374
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054013136 Issued in IL
Legal business name
MEDIDERM INC.
Doing business as
MedidermRx
Practice address
650 W Lake Cook Rd Ste 150
Buffalo Grove, IL 60089-2082
Phone
(800) 966-0670
Fax
(800) 965-3180
NPI assigned
Mar 3, 2008
Last updated
Jan 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Laurel Linton
Title
Owner
Phone
(800) 966-0670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054013136 IL Primary

Addresses

Primary practice location

650 W Lake Cook Rd Ste 150
Buffalo Grove, IL 60089-2082

Mailing address

PO Box 1535
Morton Grove, IL 60053-7535
Phone (847) 966-3192

Other names 1

  • MedidermRx Doing business as

National Provider Directory

National Provider Directory

Locations

650 W Lake Cook Rd
Ste 150
Buffalo Grove, IL 60089
Phone (800) 966-0670

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1033389374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600537535",
            "telephone_number": "847-966-3192",
            "fax_number": "847-966-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W LAKE COOK RD STE 150",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892082",
            "telephone_number": "800-966-0670",
            "fax_number": "800-965-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIDERM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "LINTON",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-966-0670",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054013136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedidermRx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.