Provider Demographics
NPI:1588749568
Name:DOCS DRUGS LTD
Entity type:Organization
Organization Name:DOCS DRUGS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:HARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-458-6104
Mailing Address - Street 1:455 E REED ST
Mailing Address - Street 2:
Mailing Address - City:BRAIDWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60408-2090
Mailing Address - Country:US
Mailing Address - Phone:815-458-6104
Mailing Address - Fax:815-458-6158
Practice Address - Street 1:304 SUNSET DR
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:IL
Practice Address - Zip Code:61752-1679
Practice Address - Country:US
Practice Address - Phone:309-962-3627
Practice Address - Fax:309-962-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000691332B00000X
IL054-0143793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054-014379OtherPHARMACY LIC
14-72618OtherNABP
IL=========019Medicaid
0194080019Medicare NSC