OLYMPIA FIELDS PHARMACY INC (NPI# 1104930098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104930098 |
| Entity Type | Organization |
| Organization Name | OLYMPIA FIELDS PHARMACY INC |
| Other Organization Name | BIENESTAR PHARMACY |
| Practice Address |
966 W 21st St Chicago IL 60608-4511 |
| Mailing Address |
966 W 21st St Ste 104 Chicago IL 60608-4511 |
| Practice Telephone | 3122262266 |
| Practice Fax Number | 3122269766 |
| Mailing Telephone | 3122262266 |
| Mailing Fax Number | 3122269766 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2017-02-21 |
| Authorized Official Name | AKIL GHOGAWALA (PHCY MGR) |
| Authorized Official Telephone | 8474203789 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054015813 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023192 | 01 |
| Other Name | Type Code |
|---|---|
| BIENESTAR PHARMACY | Doing Business As Name - Organization |
| Street Address |
966 W 21ST ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60608-4511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003885005 | Gaetano Fernando Perego | Obstetrics & Gynecology | 966 W 21st St, Chicago, IL 60608-4511 | 2006-03-14 |
| 1518579168 | Ricardo Orozco | Nurse Practitioner | 966 W 21st St, Chicago, IL 60608-4511 | 2020-08-17 |
| 1821609306 | Alivio Medical Center, Inc. | Clinic/Center | 966 W 21st St, Chicago, IL 60608-4511 | 2020-08-10 |
| 1659938157 | Louis Alamilla | Dietitian, Registered | 966 W 21st St, Chicago, IL 60608-4511 | 2019-05-21 |
| 1851872741 | Kiyomi Kimble | Midwife | 966 W 21st St, Chicago, IL 60608-4511 | 2018-08-28 |
| 1134632516 | Melissa Ray House | Midwife | 966 W 21st St, Chicago, IL 60608-4511 | 2017-11-08 |
| 1659899755 | Natalia Torres | Nurse Practitioner | 966 W 21st St, Chicago, IL 60608-4511 | 2017-09-08 |
| 1669996708 | Estela Melgoza | Counselor | 966 W 21st St, Chicago, IL 60608 | 2017-07-31 |
| 1649654484 | Fatima Saaduddin | Dentist | 966 W 21st St, Chicago, IL 60608-4511 | 2015-07-10 |
| 1457757247 | Sarah Kathryn Quirk | Advanced Practice Midwife | 966 W 21st St, Chicago, IL 60608-4511 | 2014-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390047 | Bethuna Shields | Occupational Therapist | 1401 South California Ave, Chicago, IL 60608 | 2020-06-11 |
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1205481058 | Joshua Hartman | Pharmacist | 345 Csb Mc 884, 840 S. Wood St, Chicago, IL 60608 | 2019-08-08 |
| 1194386706 | Mount Sinai Hospital, Chicago | Internal Medicine | Mount Sinai Hospital, 1500 S Fairfield Ave, Chicago, IL 60608 | 2019-06-25 |
| 1841754256 | Julia Bates | Occupational Therapist | 1640 W. Roosevelt Rd., 415 Dhsp (mc 726), Chicago, IL 60608 | 2019-01-30 |
| 1194205781 | Anais J Robles | Contractor | 1626 S Allport St, Chicago, IL 60608 | 2018-08-14 |
| 1114412970 | Dmitri Zbarsky | Internal Medicine | 1500 South Fairfield Ave., F-914, Chicago, IL 60608 | 2018-06-25 |
| 1740773050 | Alexia Ilian Derma Salazar | Speech-Language Pathologist | 2301 W 19th St - 3rd Floor Rear, Chicago, IL 60608 | 2018-06-11 |
| 1912424730 | Pareen Modi | Pharmacist | 2539 South Western Avenue, Chicago, IL 60608 | 2017-08-23 |
| 1952824302 | Raquel Gonzalez Heredia | Surgery | 1500 South Fairfield Ave, Chicago, IL 60608 | 2017-07-18 |
| Find all providers in zip 60608 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1558994921 | Diaz Holdings, Inc. | Pharmacy | 3204 W Lawrence Ave, Chicago, IL 60625-5209 | 2020-02-13 |
| 1427698349 | Heena Vital Rx, Inc. | Pharmacy | 1525 E 55th St Ste 103, Chicago, IL 60615-5514 | 2020-01-08 |
| 1952944563 | Ameer Pharmacy Inc. | Pharmacy | 104 W 111th St, Chicago, IL 60628-4215 | 2019-10-26 |
| 1255981106 | Elsdon Pharmacy, Inc. | Pharmacy | 4254 W 55th St Ste 100, Chicago, IL 60632-4642 | 2019-09-12 |
| 1346702669 | Cardinal Health 132 LLC | Pharmacy | 641 W 63rd St Ste 100, Chicago, IL 60621-2032 | 2019-04-04 |
| 1245703982 | Luna Pharmacy At Madison LLC | Pharmacy | 3171 W Madison St Ste 2, Chicago, IL 60612-1809 | 2019-01-04 |
| 1427534742 | Genoa Healthcare, LLC | Pharmacy | 4318 S State St Ste 26, Chicago, IL 60609-3701 | 2018-07-19 |
| 1356843072 | Advanced Care Rx LLC | Pharmacy | 11422 S Western Ave Ste 101, Chicago, IL 60643-4120 | 2018-03-08 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.