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General NPI Number Information
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NPI Number | 1104554823
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Entity Type | Organization
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Legal Business Name | DOWNTOWN DISCOUNT DRUGS
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 325 W STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61101-1103
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Country | US
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Telephone | 815-962-2166
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Fax | 815-962-9539
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Provider Business Mailing Address
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Address Line | 325 W STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61101-1103
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Country | US
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Telephone | 815-962-2166
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Fax | 815-962-9539
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | RAJESH PATEL
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Credential | RPH
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Telephone | 815-962-2166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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