| NPI | 1114478500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAL ROZENE President 217-994-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054.020171) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2023-12-01 |