American Drug Stores LLC

Organization Active NPI Community/Retail Pharmacy · Alsip, IL

NPI 1477500932 · NPPES record last updated Jul 10, 2018

Key facts

NPI
1477500932
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
054-005341 (IL)
Legal business name
AMERICAN DRUG STORES LLC
Practice address
12001 S Pulaski Rd
Alsip, IL 60803
Phone
(708) 389-2725
Fax
(708) 389-2786
NPI assigned
May 30, 2006
Organization subpart
No

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Corporate family (same tax ID) 24

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930085945 IL DME Supplier - Pharmacy
DME Supplier - Grocery Store
1052216835 Practice locations: Alsip, IL

National Provider Directory

Tax ID family
Osco Drug 956 (185 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054-005341 IL Yes

Addresses

Primary practice location

12001 S Pulaski Rd
Alsip, IL 60803

Mailing address

250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940

Other identifiers

IdentifierTypeStateIssuer
2022700OtherPK

Other names

  • OSCO DRUG #3098 Doing business as

Other providers in Alsip, IL

All providers in Alsip, IL · Community/Retail Pharmacy in Illinois

Sources for this page

Verify at the official NPI Registry.