Organization
LA VIDA PHARMACY INC
Active
Other names
La Vida Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JITESH PATEL RPH (OWNER, PHARMACIST)
(847) 551-5379
Entity
Organization
Contact information
Practice address
455 E MAIN ST, EAST DUNDEE, IL 60118-1529
(847) 551-5379
(224) 484-8247
Mailing address
1412 PINE COVE CT, DARIEN, IL 60561-4999
(847) 551-5379
(224) 484-8247
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.018817
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138271
PK
—
Enumeration date
12/18/2012
Last updated
03/01/2017
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