Provider Demographics
NPI:1801883608
Name:TVS RX INC
Entity type:Organization
Organization Name:TVS RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TILAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARWAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPH
Authorized Official - Phone:773-379-7773
Mailing Address - Street 1:5470 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644-4031
Mailing Address - Country:US
Mailing Address - Phone:773-379-7773
Mailing Address - Fax:773-379-1020
Practice Address - Street 1:5470 W MADISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-4031
Practice Address - Country:US
Practice Address - Phone:773-379-7773
Practice Address - Fax:773-379-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X
IL5400143423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2017030OtherPK
2017030OtherPK
IL4525180001Medicare NSC