Provider Demographics
NPI:1588996136
Name:BEST VITAL RX INC
Entity type:Organization
Organization Name:BEST VITAL RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:NISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-599-8550
Mailing Address - Street 1:15 TOWER CT
Mailing Address - Street 2:SUITE #195
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3336
Mailing Address - Country:US
Mailing Address - Phone:847-599-8550
Mailing Address - Fax:847-599-8549
Practice Address - Street 1:15 TOWER CT STE 195
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3340
Practice Address - Country:US
Practice Address - Phone:847-599-8550
Practice Address - Fax:847-599-8549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054-0168153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1484081OtherNCPDP PROVIDER IDENTIFICATION NUMBER