Addison Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ADDISON PHARMACY INC

Practice address

414 W Lake St
Addison, IL 60101-2305

Phone

(630) 543-0988

Fax

(630) 543-0918

NPI assigned

Aug 4, 2006

Last updated

Jan 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kerul T Mehta, RPH

Title

Pharmacy Manager

Phone

(630) 543-0988

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Addison Pharmacy, Inc

  dba Westchester Pharmacy

  • Community/Retail Pharmacy
  • Bellwood, IL
  • NPI 1104217389

  O20130530000219

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1861400905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012305",
            "telephone_number": "630-543-0988",
            "fax_number": "630-543-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012305",
            "telephone_number": "630-543-0988",
            "fax_number": "630-543-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDISON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "KERUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "630-543-0988",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addison Fire Protection District No 1
• Addison Medical Associates LTD (Medical Square)
• Addison Medical Office, Inc
• Addison Medical Square, LTD.
• Addison Pharmacy & Medical Supply
• Addison Podiatry Center PLLC
• Addison School District 4
• Addison Swift Dental Center PLLC (Addison Smiles)
• Neerja Aggarwal, DDS
• Emmanuel N Agomo, PA-C

• Community/Retail Pharmacy in Addison, IL
• Providers in Addison, 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 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.