Provider Demographics
NPI:1649821091
Name:NEWPATH VITAL RX INC.
Entity type:Organization
Organization Name:NEWPATH VITAL RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MS
Authorized Official - First Name:NISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-656-5797
Mailing Address - Street 1:425 LAKE ST STE A
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-1464
Mailing Address - Country:US
Mailing Address - Phone:224-788-8557
Mailing Address - Fax:224-788-8798
Practice Address - Street 1:425 LAKE ST STE A
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1464
Practice Address - Country:US
Practice Address - Phone:224-788-8557
Practice Address - Fax:224-788-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy