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Organization

VIRTUS OHIO PHARMACY, LLC

Active
Other names
Centerville LTC Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
RUTUL SHAH (PRINCIPAL)
(312) 391-6845
Entity
Organization

Contact information

Practice address
9352 LEBANON PIKE STE B, CENTERVILLE, OH 45458-3843
(937) 435-5751
(937) 435-5759
Mailing address
947 W MONTANA ST APT 3E, CHICAGO, IL 60614-2429
(312) 391-6845

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PSNH.022586600-
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2160200
PK
Enumeration date
06/27/2016
Last updated
06/27/2016
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