Provider Demographics
NPI:1871156547
Name:PROHEALTH PHARMACY LLC
Entity type:Organization
Organization Name:PROHEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:847-423-2242
Mailing Address - Street 1:4709 GOLF RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1238
Mailing Address - Country:US
Mailing Address - Phone:847-423-2242
Mailing Address - Fax:847-423-2249
Practice Address - Street 1:4709 GOLF RD STE 110
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1238
Practice Address - Country:US
Practice Address - Phone:847-423-2242
Practice Address - Fax:847-423-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy