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General NPI Number Information
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NPI Number | 1740604214
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Entity Type | Organization
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Legal Business Name | RX AT HOME, LLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 892 E ROOSEVELT RD
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City | LOMBARD
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State | IL
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Zip | 60148-4745
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Country | US
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Telephone | 630-400-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 892 E ROOSEVELT RD
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City | LOMBARD
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State | IL
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Zip | 60148-4745
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MOHAMMED S KHAN
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Credential |
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Telephone | 630-400-1074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 051293453
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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 | 051293453
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License Number State | IL
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