200 PHARMACY INC (NPI# 1285635094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285635094 |
| Entity Type | Organization |
| Organization Name | 200 PHARMACY INC |
| Practice Address |
9133 S Stony Island Ave Chicago IL 60617-3512 |
| Practice Telephone | 7733744550 |
| Practice Fax Number | 7733744660 |
| Mailing Telephone | 7733744550 |
| Mailing Fax Number | 7733744660 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2011-05-23 |
| Authorized Official Name | SHERMAN WHITE (REG PHARMACIST AND VP) |
| Authorized Official Telephone | 7733744550 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
051032504 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 1445178 | 01 |
| Street Address |
9133 S STONY ISLAND AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-3512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174523518 | Abayomi A Adeyemi | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2005-07-28 |
| 1265942304 | Lance Parsley | Pharmacist | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2017-10-03 |
| 1902073281 | Abayomi Adeyemi, M.d,s.c | Clinic/Center | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2008-05-15 |
| 1851562300 | Mahoney Home Healthcare Services Inc. | Home Health | 9133 S Stony Island Ave, Suite 2, Chicago, IL 60617-3512 | 2008-03-12 |
| 1316135841 | Uday Shah Md Sc | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3936 | 2007-10-10 |
| 1861538712 | Ijaz Ahmad | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2007-01-29 |
| 1033263371 | Adeebur Rahman Md Sc | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2007-01-23 |
| 1871671248 | Herman Leo Morgan | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2006-11-01 |
| 1730107715 | Uday Shah | Internal Medicine | 9133 S Stony Island Ave, Chicago, IL 60617-3512 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 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 | ||||
Please comment or provide details below to improve the information on 200 PHARMACY INC.
| 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.