| NPI | 1437420460 |
|---|---|
| Doing Business As | AVICENNA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | AHMED MAHAFZAH Owner, PIC, AO 708-529-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054017745) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2023-08-30 |