Healthcare Provider Details

I. General information

NPI: 1417297185
Provider Name (Legal Business Name): TOTAL CARE RX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 10/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 DELTA LN
ELK GROVE VILLAGE IL
60007-6303
US

IV. Provider business mailing address

2480 DELTA LN
ELK GROVE VILLAGE IL
60007-6303
US

V. Phone/Fax

Practice location:
  • Phone: 630-509-2963
  • Fax: 847-734-1822
Mailing address:
  • Phone: 630-509-2963
  • Fax: 847-734-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TONY ORSINI
Title or Position: CEO
Credential:
Phone: 630-509-2963