Organization
TVS RX INC
Active
Other names
MADISON PINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TILAK MARWAHA MS RPH (PRESIDENT)
(773) 379-7773
Entity
Organization
Contact information
Practice address
5470 W MADISON ST, CHICAGO, IL 60644-4031
(773) 379-7773
(773) 379-1020
Mailing address
5470 W MADISON ST, CHICAGO, IL 60644-4031
(773) 379-7773
(773) 379-1020
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
540014342
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017030
PK
—
Enumeration date
10/05/2005
Last updated
03/19/2014
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