Provider Demographics
NPI:1114438504
Name:TELESCRIPT PHARMACY INC.
Entity Type:Organization
Organization Name:TELESCRIPT PHARMACY INC.
Other - Org Name:TELESCRIPT PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:CORBIN
Authorized Official - Last Name:EDELCUP
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:847-800-2138
Mailing Address - Street 1:687 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4331
Mailing Address - Country:US
Mailing Address - Phone:630-299-3900
Mailing Address - Fax:630-429-9704
Practice Address - Street 1:687 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4331
Practice Address - Country:US
Practice Address - Phone:630-299-3900
Practice Address - Fax:630-429-9704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL333600000X
3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy