Maywood Community Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054016702 Issued in IL

Legal business name

MAYWOOD COMMUNITY PHARMACY LLC

Doing business as

maywood community pharmacy. llc

Practice address

1411 S 5TH Ave
Maywood, IL 60153-2128

Phone

(708) 345-4658

NPI assigned

Sep 21, 2009

Organization subpart

No

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

Authorized official

Name

Jitesh Patel

Title

Pharmacist

Phone

(630) 999-5298

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• maywood community pharmacy. llc Doing business as

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1215261482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 S 5TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532128",
            "telephone_number": "708-345-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S 5TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532128",
            "telephone_number": "708-345-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYWOOD COMMUNITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JITESH",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "630-999-5298"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1483851",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "maywood community pharmacy. llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Maywood, IL
• Providers in Maywood, 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 Nov 4, 2009; 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.