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Organization
LETITRIDE INC
Active
Organization
LETITRIDE INC
Active
Parent organization
LETITRIDE INC
Other names
Fairbury Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
LETITRIDE INC
Authorized official
ERIC DANIEL URBANOWSKI (AUTHORIZED OFFICIAL)
(815) 669-9904
Entity
Organization
Contact information
Practice address
501 W OAK ST, FAIRBURY, IL 61739-1444
(815) 692-1250
(815) 692-1253
Mailing address
501 W OAK ST, FAIRBURY, IL 61739-1444
(815) 692-1250
(815) 945-7466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4737841114002
—
IL
Enumeration date
10/13/2020
Last updated
07/17/2026
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