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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
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
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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