Organization
LETITRIDE INC
Active
Other names
Chenoa Rx LTC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TAVEGGIA (OWNER/RPH)
(815) 945-4211
Entity
Organization
Contact information
Practice address
1000 E CEMETERY AVE, CHENOA, IL 61726-1298
(815) 945-4211
(815) 945-7466
Mailing address
1000 E CEMETERY AVE, CHENOA, IL 61726-1298
(815) 945-4211
(815) 945-7466
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
054.019487
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159288
PK
—
Enumeration date
04/11/2016
Last updated
01/08/2025
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