NPIMap

Organization Active NPI

Ballin Pharmacy LTC Inc

  • Long Term Care Pharmacy
  • Chicago, IL
National Provider Identifier
1083856561
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
054016603 Issued in IL
Legal business name
BALLIN PHARMACY LTC INC
Doing business as
Ballin Pharmacy LTC Inc
Practice address
3327 N Paulina St Ste 1
Chicago, IL 60657-1035
Phone
(773) 348-3009
Fax
(773) 348-0028
NPI assigned
Mar 31, 2009
Last updated
Mar 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
WM Mattson
Title
Owner RPH
Phone
(773) 348-0027

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 054016603 IL Primary

Addresses

Primary practice location

3327 N Paulina St Ste 1
Chicago, IL 60657-1035

Mailing address

3327 N Paulina St Ste 1
Chicago, IL 60657-1035
Phone (773) 348-3009

Other identifiers 1

IdentifierTypeStateIssuer
2119620OtherPK

Other names 1

  • BALLIN PHARMACY LTC INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ballin Pharmacy LTC Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1083856561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 N PAULINA ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571035",
            "telephone_number": "773-348-3009",
            "fax_number": "773-348-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 N PAULINA ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571035",
            "telephone_number": "773-348-3009",
            "fax_number": "773-348-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLIN PHARMACY LTC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-31",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "WM",
        "authorized_official_title_or_position": "OWNER RPH",
        "authorized_official_telephone_number": "773-348-0027"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054016603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BALLIN PHARMACY LTC INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.