Healthcare Provider Details

I. General information

NPI: 1730401043
Provider Name (Legal Business Name): VCARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N CALIFORNIA AVE
CHICAGO IL
60659-2699
US

IV. Provider business mailing address

6201 N CALIFORNIA AVE
CHICAGO IL
60659-2699
US

V. Phone/Fax

Practice location:
  • Phone: 773-465-1144
  • Fax:
Mailing address:
  • Phone: 773-465-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054-17137
License Number StateIL

VIII. Authorized Official

Name: SHOUKATH AHMED
Title or Position: PRESIDENT
Credential:
Phone: 630-926-8486