| NPI | 1104185131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: AZ Y005744) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2024-01-29 |