| NPI | 1124710835 |
|---|---|
| Doing Business As | LOGAN SQUARE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SELMA DZELIL VP Regional Director 815-715-8502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-09-25 |