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General NPI Number Information
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NPI Number | 1588996136
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Entity Type | Organization
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Legal Business Name | BEST VITAL RX INC
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 15 TOWER CT STE 195
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City | GURNEE
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State | IL
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Zip | 60031-3340
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Country | US
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Telephone | 847-599-8550
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Fax | 847-599-8549
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Provider Business Mailing Address
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Address Line | 15 TOWER CT SUITE #195
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City | GURNEE
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State | IL
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Zip | 60031-3336
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Country | US
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Telephone | 847-599-8550
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Fax | 847-599-8549
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | NISHA JANI
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Credential |
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Telephone | 847-599-8550
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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 | 054-016815
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License Number State | IL
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