| NPI | 1043269442 |
|---|---|
| Doing Business As | PROVENA HOME INFUSION URBANA |
| Entity Type | Organization |
| Authorized Contact | MARGARET C GLEASON President CEO 815-806-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251F00000X Home Infusion (Licence: IL 1010264) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |