Provider Demographics
NPI:1437332467
Name:J S VITAMINS AND MORE INC
Entity Type:Organization
Organization Name:J S VITAMINS AND MORE INC
Other - Org Name:HAWTHORNE HEALTH AND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-656-1917
Mailing Address - Street 1:4785 W CERMATZ
Mailing Address - Street 2:
Mailing Address - City:CIRCERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804
Mailing Address - Country:US
Mailing Address - Phone:708-656-1917
Mailing Address - Fax:708-656-1919
Practice Address - Street 1:4785 W CERMATZ
Practice Address - Street 2:
Practice Address - City:CIRCERO
Practice Address - State:IL
Practice Address - Zip Code:60804
Practice Address - Country:US
Practice Address - Phone:708-656-1917
Practice Address - Fax:708-656-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
IL0540163423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1481453OtherNCPDP PROVIDER IDENTIFICATION NUMBER