| NPI | 1184384828 |
|---|---|
| Doing Business As | BOURBONNAIS PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PRADIP VACHHANI President 815-401-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2023-05-31 |