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General NPI Number Information
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NPI Number | 1205496296
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Entity Type | Organization
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Legal Business Name | VITA PHARMACY INC
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 279-281 W ELK TRAIL RD
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City | CAROL STREAM
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State | IL
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Zip | 60188
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Country | US
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Telephone | 630-517-8023
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Fax | 630-517-8071
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Provider Business Mailing Address
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Address Line | 279-281 W ELK TRAIL RD
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City | CAROL STREAM
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State | IL
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Zip | 60188
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Country | US
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Telephone | 630-517-8023
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Fax | 630-517-8071
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Authorized Official
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Title or Position | OWNER
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Name | BHAGVATIBEN PATEL
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Credential |
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Telephone | 217-418-9581
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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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