NPI 1114775806 · live from the CMS NPI Registry
1918 Winter Street Operating Co LLC
Pharmacy, Community/Retail Pharmacy in Bannockburn, IL. National Provider Identifier 1114775806, active.
NPI record
| NPI | 1114775806 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 2999 Waukegan Rd, Bannockburn, IL 60015 |
| Practice phone | 847-267-0364 |
| Mailing address | 7 Corporate Dr, Keene, NH 03431 |
| Enumerated | May 8, 2024 |
| Last updated | July 24, 2024 |
| Authorized official | Kevin Mcnamara, Authorized Person |
| Other names | Mariano'S Pharmacy #0542 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.