| NPI | 1073300729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMISHIA LITTLE Authorized Manager 773-960-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-05-07 |