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General NPI Number Information
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NPI Number | 1851816763
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Entity Type | Organization
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Legal Business Name | QUIK SCRIPTS OF NORTHWEST INDIANA LLC
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 10865 MAPLE LN
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City | SAINT JOHN
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State | IN
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Zip | 46373-8513
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Country | US
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Telephone | 219-365-9701
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Fax | 219-365-9711
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Provider Business Mailing Address
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Address Line | 10865 MAPLE LN
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City | SAINT JOHN
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State | IN
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Zip | 46373-8513
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Country | US
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Telephone | 219-924-9540
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Fax | 219-924-9535
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Authorized Official
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Title or Position | OWNER
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Name | DAVID DAVILA
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Credential | RPH
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Telephone | 219-671-7371
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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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