# LA VIDA PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** La Vida Pharmacy Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023354115
- **Authorized official:** JITESH PATEL RPH (OWNER, PHARMACIST)
- **Authorized official phone:** (847) 551-5379

## Contact information

- **Practice address:** 455 E MAIN ST, EAST DUNDEE, IL 60118-1529
- **Practice address phone:** (847) 551-5379
- **Practice address fax:** (224) 484-8247
- **Mailing address:** 1412 PINE COVE CT, DARIEN, IL 60561-4999
- **Mailing address phone:** (847) 551-5379
- **Mailing address fax:** (224) 484-8247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054.018817 | IL | Yes |

## Other

- **Enumeration date:** 12/18/2012
- **Last updated:** 03/01/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2138271 | PK | — |