| NPI | 1174040562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN NIELSEN Ass Treasure 847-315-3523 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |