| NPI | 1003587981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SALEM Member 618-659-5569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-09-21 |