Vital Care Of Wauconda
LBN: Wauconda Pharmacy, Inc.
Vital Care Of Wauconda is an health care organization with primary practice located at 222 S Main St , Wauconda IL 60084-1828. The organization recently has 10 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Customized Equipment, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Oxygen Equipment & Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Mail Order Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty.
Wauconda Pharmacy, Inc. can be contacted via phone (847) 526-2591, or through Bruner, Terry J via phone (847) 526-2591.
Contact Information
Primary practice address
222 S Main St
Wauconda IL 60084-1828
Phone: (847) 526-2591
Fax: (847) 526-1598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 054-006291 | Illinois |
| Suppliers / Customized Equipment | 332BC3200X | 054-006291 | Illinois |
| Suppliers / Parenteral & Enteral Nutrition | 332BP3500X | 054-006291 | Illinois |
| Suppliers / Oxygen Equipment & Supplies | 332BX2000X | 054-006291 | Illinois |
| Suppliers / Pharmacy | 333600000X | 054-006291 | Illinois |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 054-006291 | Illinois |
| Suppliers / Home Infusion Therapy Pharmacy | 3336H0001X | 054-006291 | Illinois |
| Suppliers / Long Term Care Pharmacy | 3336L0003X | 054-006291 | Illinois |
| Suppliers / Mail Order Pharmacy | 3336M0002X | 054-006291 | Illinois |
| Suppliers / Specialty Pharmacy | 3336S0011X | 054-006291 | Illinois |
Profile Details
| NPI number | 1568571420 |
|---|---|
| LBN Legal business name | Wauconda Pharmacy, Inc. |
| DBA Doing business as | Vital Care Of Wauconda |
| Authorized official | Bruner, Terry J |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Nov 7th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568571420 | NPPES |
| Illinois | Other | IL3147 | MEDICARE PART B |
| Illinois | Other | 1428196 | MEDICARE PART B |
| Illinois | MEDICAID | 36368683001 | MEDICARE PART B |
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