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General NPI Number Information
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NPI Number | 1285661553
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Entity Type | Organization
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Legal Business Name | RILEY DRUGS INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 415 W STATE ST
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City | GENEVA
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State | IL
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Zip | 60134-2157
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Country | US
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Telephone | 630-232-0650
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Fax | 630-232-0637
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Provider Business Mailing Address
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Address Line | 415 W STATE ST
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City | GENEVA
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State | IL
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Zip | 60134-2157
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Country | US
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Telephone | 630-232-0650
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Fax | 630-232-0637
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Authorized Official
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Title or Position | CORP PRES
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Name | TIMOTHY D RILEY
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Credential | RPH
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Telephone | 630-232-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 054007941
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054-007941
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License Number State | IL
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