Bolling Prescription Lab Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054005174 Issued in IL

Legal business name

BOLLING PRESCRIPTION LAB INC

Doing business as

Roseland Pharmacy

Practice address

11254 S Michigan Ave
Chicago, IL 60628-4941

Phone

(773) 568-1050

Fax

(773) 568-1051

NPI assigned

Jul 30, 2006

Last updated

Oct 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Howard Bolling

Title

Owner

Phone

(773) 568-1050

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ROSELAND PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1346255957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11254 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284941",
            "telephone_number": "773-568-1050",
            "fax_number": "773-568-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11254 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284941",
            "telephone_number": "773-568-1050",
            "fax_number": "773-568-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLLING PRESCRIPTION LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "BOLLING",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-568-1050"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054005174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6062801",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1429693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROSELAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Bolis, LPC
• Geeta Bollam, MD
• Morgan Bollech, PHARMD
• Beth Bollenbach, LCSW
• Virginia Lawton Boller, LCSW
• Nicholas Bollinger, LSW
• Stephanie Bollow
• James Bolo, LCSW
• Jennifer Bolognani, APRN
• Maureen K Bolon, MD

• 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 Oct 8, 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.