| NPI | 1144790791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH D MALAS CFO 815-971-6738 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2025-06-10 |