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Organization
LAVIR PHARMACY INC
Active
Organization
LAVIR PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRITKUMAR PATEL RPH (MANAGER RPH IN CHARGE)
(773) 853-2374
Entity
Organization
Contact information
Practice address
4959 W BELMONT AVE, CHICAGO, IL 60641-4332
(773) 853-2374
(773) 853-2365
Mailing address
4959 W BELMONT AVE, CHICAGO, IL 60641-4332
(773) 853-2374
(773) 853-2365
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054016489
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117316
PK
—
Enumeration date
09/17/2008
Last updated
12/22/2017
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