MEDICARE: QUIK SCRIPTS OF NORTHWEST INDIANA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265948848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUIK SCRIPTS OF NORTHWEST INDIANA LLC

Provider Business Mailing Address
First Line	:	715 S DIXIE HWY
Second Line	:
City	:	BEECHER
State	:	IL
Zip	:	60401-3668
Country	:	US
Telephone Number	:	708-231-6343
Fax Number	:	708-231-6483

Provider Business Practice Location Address
First Line	:	715 S DIXIE HWY
Second Line	:
City	:	BEECHER
State	:	IL
Zip	:	60401-3668
Country	:	US
Telephone Number	:	708-231-6343
Fax Number	:	708-231-6483

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID DAVILA
Credential	:	RPH
Telephone Number	:	708-231-6343

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	10/30/2023

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Directions to “QUIK SCRIPTS OF NORTHWEST INDIANA LLC ” Practice Location

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