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General NPI Number Information
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NPI Number | 1669231981
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Entity Type | Organization
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Legal Business Name | KWIKRX BURBANK #0512
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 4817 W 83RD ST
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City | BURBANK
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State | IL
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Zip | 60459-2790
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Country | US
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Telephone | 708-866-2606
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Fax | 708-866-2607
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Provider Business Mailing Address
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Address Line | 4817 W 83RD ST STE 3
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City | BURBANK
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State | IL
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Zip | 60459-2790
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Country | US
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Telephone | 708-866-2606
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Fax | 708-866-2607
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MUHAMMAD TAHA
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Credential |
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Telephone | 708-866-2606
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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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