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General NPI Number Information
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NPI Number | 1114438504
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Entity Type | Organization
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Legal Business Name | TELESCRIPT PHARMACY INC.
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 687 WAUKEGAN RD
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City | DEERFIELD
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State | IL
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Zip | 60015-4331
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Country | US
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Telephone | 630-299-3900
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Fax | 630-429-9704
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Provider Business Mailing Address
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Address Line | 687 WAUKEGAN RD
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City | DEERFIELD
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State | IL
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Zip | 60015-4331
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Country | US
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Telephone | 630-299-3900
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Fax | 630-429-9704
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRENT CORBIN EDELCUP
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Credential | PHARMD
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Telephone | 847-800-2138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | IL
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