Olympia Fields Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054015813 Issued in IL

Legal business name

OLYMPIA FIELDS PHARMACY INC

Practice address

966 W 21St St
Chicago, IL 60608-4511

Phone

(312) 226-2266

Fax

(312) 226-9766

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Akil Ghogawala, PHARM.D.

Title

Phcy MGR

Phone

(847) 420-3789

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• BIENESTAR PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1104930098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 W 21ST ST",
            "address_2": "STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "312-226-2266",
            "fax_number": "312-226-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 W 21ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "312-226-2266",
            "fax_number": "312-226-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA FIELDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "GHOGAWALA",
        "authorized_official_first_name": "AKIL",
        "authorized_official_title_or_position": "PHCY MGR",
        "authorized_official_telephone_number": "847-420-3789",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054015813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2023192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BIENESTAR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Temitope Olutade, PMHNP
• Gabriel Oluwakotanmi, CNS
• Ofelia Olvera-Auburn, COTA
• Caroline Elizabeth Olvera, M.D.
• Sandie Maria Olvera, PTA
• Olympus Healthcare Inc
• Om Jay Gayatri Ma Inc
• Om Red Ganesh Inc
• Megan Eileen Omahony, APN
• Janice Susan Omalley, PSYD

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.