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Contact Information

LETITRIDE, INC.
501 W OAK STREET
FAIRBURY, IL61739
 Phone: 815-945-4211
 Fax: 815-945-7466
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for LETITRIDE, INC.

NPI # 1386242352
LBN Legal business name LETITRIDE, INC.
Authorized official ROBERT TAVEGGIA - (OWNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/13/2020
Last updated 07/25/2025 - About 10 months ago
Identifiers
IL Medicaid 4737841114002
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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