Am Vincennes Drug, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

AM VINCENNES DRUG, INC

Practice address

1536 Vincennes Ave Ste 101
Chicago Heights, IL 60411-3458

Phone

(708) 300-2912

NPI assigned

May 6, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dipti Bhatt

Title

President

Phone

(708) 300-2912

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1720609266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 VINCENNES AVE STE 101",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113458",
            "telephone_number": "708-300-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 VINCENNES AVE STE 101",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113458",
            "telephone_number": "708-300-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AM VINCENNES DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "BHATT",
        "authorized_official_first_name": "DIPTI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-300-2912"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.