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Contact Information

PRIME PLUS LAKEVIEW LLC
3156 N CLARK ST
CHICAGO, IL60657
 Phone: 773-568-8340
 Fax: 773-568-8341
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PRIME PLUS LAKEVIEW LLC

NPI # 1306954433
LBN Legal business name PRIME PLUS LAKEVIEW LLC
Authorized official AMRO ATASSI - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/28/2006
Last updated 11/09/2021 - About 5 years ago
Identifiers
IL License # 054005995
IL Medicaid =========
IL Other 1431523 NABP/NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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