NPI | 1205146917 |
---|---|
Doing Business As | ILLINI PHARMACY SERVICES |
Entity Type | Organization |
Authorized Contact | DARRIN SHASTEEN Owner 217-791-6340 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IL 054.017565) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0003X Pharmacy, Community/Retail Pharmacy | |
Enumeration Date | 2010-10-15 |
Last Update Date | 2017-02-21 |