MEDICARE: VALUE RX FARMACIA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	054.017935	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2135903	OTHER		PK

General Provider Information

NPI Number	:	1568726255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALUE RX FARMACIA INC

Provider Business Mailing Address
First Line	:	3220 W ARMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3797
Country	:	US
Telephone Number	:	773-904-8747
Fax Number	:	773-904-7234

Provider Business Practice Location Address
First Line	:	3220 W ARMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3797
Country	:	US
Telephone Number	:	773-904-8747
Fax Number	:	773-904-7234

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	RASHMI SHAH
Credential	:
Telephone Number	:	773-904-8747

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	05/07/2015

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Directions to “VALUE RX FARMACIA INC ” Practice Location

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