| NPI | 1013201094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: VA 0201004394) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2024-01-18 |