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NPI Code Detail

MEDICARE: VAISHALI PHARMACY INC

MEDICARE: VAISHALI PHARMACY INC
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
13336C0002XClinic Pharmacy
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy054013957IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12019831OTHERPK

General Provider Information

NPI Number : 1548275175
Entity Type Code : Organization
Provider Name (Legal Business Name) : VAISHALI PHARMACY INC
Provider Business Mailing Address
First Line : 1206 RAYMOND TURN
Second Line :
City : BOURBONNAIS
State : IL
Zip : 60914-4799
Country : US
Telephone Number : 773-521-7422
Fax Number : 773-521-6986
Provider Business Practice Location Address
First Line : 3147 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3307
Country : US
Telephone Number : 773-521-7422
Fax Number : 773-521-6986
Authorized Official
Title or Position : PRESIDENT
Name : VISHAL PATEL
Credential : RPH
Telephone Number : 773-521-7422
Provider Enumeration Date : 07/30/2006
Last Update Date : 12/07/2021

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Directions to “VAISHALI PHARMACY INC ” Practice Location

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