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General NPI Number Information
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NPI Number | 1972255545
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Entity Type | Organization
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Legal Business Name | DELIVERRX LLC
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1236 W BOUGHTON RD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-6568
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Country | US
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Telephone | 331-250-3527
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Fax |
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Provider Business Mailing Address
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Address Line | 238 CHARLESTON AVE
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City | ROMEOVILLE
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State | IL
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Zip | 60446-4133
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Country | US
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Telephone | 331-250-3527
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. ABENA OWUSU-ANSAH
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Credential | RPH
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Telephone | 331-250-3527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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