Forest Park Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054020100 Issued in IL

Legal business name

FOREST PARK PHARMACY INC

Practice address

331 Salem PL
Fairview Heights, IL 62208-1340

Phone

(618) 607-0200

Fax

(618) 607-0201

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Amira Jahic

Title

Vice President

Phone

(314) 645-9990

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Forest Park Pharmacy Doing business as

Tax ID family

Forest Park Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Forest Park Pharmacy

  • Community/Retail Pharmacy
  • St Louis, MO
  • NPI 1659576205
  NPD tax ID

Locations

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1952857567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SALEM PL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081340",
            "telephone_number": "618-607-0200",
            "fax_number": "618-607-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SALEM PL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081340",
            "telephone_number": "618-607-0200",
            "fax_number": "618-607-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "JAHIC",
        "authorized_official_first_name": "AMIRA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "314-645-9990"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054020100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheen Fleming
• Foot & Ankle Center, LLC
• Foot & Ankle Center, LLC
• Ford Therapy Solutions, LLC
• Tyrone D Ford, LCSW
• Fountains Eyecare Center, PC
• Warren J Fournier II, MD
• Jasper Dean Franklin
• Stephen Frazier, LCSW
• Rachel Frazure, LCSW

• Community/Retail Pharmacy in Fairview Heights, IL
• Providers in Fairview Heights, 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 18, 2017; 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.