NPIMap

Organization Active NPI

Thies-Lombard Pharmacy, Inc

  • Long Term Care Pharmacy
  • Lombard, IL
National Provider Identifier
1346875127
Registry record updated Jun 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
THIES-LOMBARD PHARMACY, INC
Practice address
211 S Main St
Lombard, IL 60148-2678
Phone
(630) 495-2333
Fax
(630) 495-2355
NPI assigned
Mar 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2022

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

Authorized official

Name
Dr. Clarke Allan Kueltzo
Title
President
Phone
(630) 495-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

211 S Main St
Lombard, IL 60148-2678

Mailing address

211 S Main St
Lombard, IL 60148-2678
Phone (630) 495-2333

Other names 1

  • Lombard Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lombard Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

211 S Main St
Lombard, IL 60148
Phone (630) 495-2333

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655510400000",
    "number": "1346875127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S MAIN ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482678",
            "telephone_number": "630-495-2333",
            "fax_number": "630-495-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S MAIN ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482678",
            "telephone_number": "630-495-2333",
            "fax_number": "630-495-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIES-LOMBARD PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A",
        "authorized_official_last_name": "KUELTZO",
        "authorized_official_first_name": "CLARKE",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-495-2333",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lombard Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; 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.