| NPI | 1114073681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE FERRICKS Store Manager 708-946-3714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: IL 049126095) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |