MEDICARE: SAV-RX-CHICAGO 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	054014093	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1470486	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1811025174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAV-RX-CHICAGO INC

Provider Business Mailing Address
First Line	:	224 N PARK AVE
Second Line	:
City	:	FREMONT
State	:	NE
Zip	:	68025-4964
Country	:	US
Telephone Number	:	800-228-2181
Fax Number	:	800-810-1394

Provider Business Practice Location Address
First Line	:	1645 W JACKSON BLVD STE 205
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3227
Country	:	US
Telephone Number	:	312-850-4293
Fax Number	:	312-421-1269

Authorized Official
Title or Position	:	VICE PRES SAV RX
Name	:	CHRISTY PITI
Credential	:
Telephone Number	:	800-228-2181

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	08/21/2012

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Directions to “SAV-RX-CHICAGO INC ” Practice Location

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