Provider Demographics
NPI:1700057304
Name:VILLAGE PHARMACY INC
Entity Type:Organization
Organization Name:VILLAGE PHARMACY INC
Other - Org Name:VILLAGE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-783-2865
Mailing Address - Street 1:2030 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:87 N AIRLITE ST
Practice Address - Street 2:G10
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4988
Practice Address - Country:US
Practice Address - Phone:847-729-1020
Practice Address - Fax:847-729-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL540164153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1481807OtherOTHER ID NUMBER