NPI | 1114309465 |
---|---|
Entity Type | Organization |
Authorized Contact | ALTAMASH KHAN Store Manager 224-619-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054.019391) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2015-06-23 |
Last Update Date | 2018-04-19 |