Berwyn Community Pharmacy

Key facts

NPI

1376846063

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

054-017555 (IL)

Legal business name

BERWYN COMMUNITY PHARMACY

Practice address

7234 Ogden Ave
Suite 1E
Riverside, IL 60546-2269

Phone

(630) 550-0565

NPI assigned

Dec 17, 2010

Organization subpart

No

Authorized official

Name

Mr. Kalpesh Patel, R.PH

Title

Chief Pharmacist

Phone

(630) 550-0565

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Riverside Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 17, 2010.

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1376846063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7234 OGDEN AVE",
            "address_2": "SUITE 1E",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462269",
            "telephone_number": "630-550-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7234 OGDEN AVE",
            "address_2": "SUITE 1E",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462269",
            "telephone_number": "630-550-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERWYN COMMUNITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KALPESH",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "630-550-0565",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054-017555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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