# AM VINCENNES DRUG, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720609266
- **Authorized official:** DIPTI BHATT (PRESIDENT)
- **Authorized official phone:** (708) 300-2912

## Contact information

- **Practice address:** 1536 VINCENNES AVE STE 101, CHICAGO HEIGHTS, IL 60411-3458
- **Practice address phone:** (708) 300-2912
- **Mailing address:** 1536 VINCENNES AVE STE 101, CHICAGO HEIGHTS, IL 60411-3458
- **Mailing address phone:** (708) 300-2912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2020
- **Last updated:** 05/06/2020