Bartlett Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Bartlett, IL

NPI 1518328186 · NPPES record last updated May 14, 2025

Key facts

NPI
1518328186
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
054019850 (IL)
Legal business name
BARTLETT PHARMACY INC
Practice address
300 W Bartlett Ave
Bartlett, IL 60103-4002
Phone
(630) 855-5178
Fax
(630) 855-5672
NPI assigned
Mar 10, 2016
Organization subpart
No

Authorized official

Name
Nahren Khoshaba, PHARMD
Title
President/Owner/Pic
Phone
(630) 855-5178

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160504000563 IL Part B Supplier - Mass Immunization (Roster Biller Only) 6800195421 Practice locations: Bartlett, IL

National Provider Directory

Tax ID family
Bartlett Pharmacy Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054019850 IL Yes

Addresses

Primary practice location

300 W Bartlett Ave
Bartlett, IL 60103-4002

Mailing address

300 W Bartlett Ave
Bartlett, IL 60103-4002
Phone (630) 855-5178

Other identifiers

IdentifierTypeStateIssuer
2159026OtherPK

Other names

  • Bartlett Pharmacy Doing business as

Other providers in Bartlett, IL

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

Sources for this page

Verify at the official NPI Registry.