Health Source Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054018075 Issued in IL

Legal business name

HEALTH SOURCE PHARMACY

Practice address

6723 Cermak Rd
Berwyn, IL 60402-2216

Phone

(773) 683-4402

NPI assigned

Jan 23, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Janet Oviedo

Title

Owner

Phone

(773) 683-4402

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1720326903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6723 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022216",
            "telephone_number": "773-683-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SOURCE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "OVIEDO",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-683-4402",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054018075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Hart, MS,CEP,CCRP,FAACVPR
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• Community/Retail Pharmacy in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.