Provider Demographics
NPI:1669231981
Name:KWIKRX BURBANK #0512
Entity type:Organization
Organization Name:KWIKRX BURBANK #0512
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-866-2606
Mailing Address - Street 1:4817 W 83RD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-2790
Mailing Address - Country:US
Mailing Address - Phone:708-866-2606
Mailing Address - Fax:708-866-2607
Practice Address - Street 1:4817 W 83RD ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2790
Practice Address - Country:US
Practice Address - Phone:708-866-2606
Practice Address - Fax:708-866-2607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy