NPIMap

Organization Active NPI

Medcentrix Inc

  • Community/Retail Pharmacy
  • Harvey, IL
National Provider Identifier
1598930752
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054016131 Issued in IL
Legal business name
MEDCENTRIX INC
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 589-2019
Fax
(708) 589-2080
NPI assigned
Apr 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Mr. Ronald J Rutkowski, RPH
Title
Pharmacy Manager
Phone
(708) 589-2019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054016131 IL Primary

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 589-2019

Other names 1

  • ingalls pro pharm 4 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ingalls Prof Pharmacy LLL10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1598930752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-589-2019",
            "fax_number": "708-589-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-589-2019",
            "fax_number": "708-589-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCENTRIX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "RUTKOWSKI",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "708-589-2019",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ingalls pro pharm 4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harvey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.