| NPI | 1215223755 |
|---|---|
| Doing Business As | KODO PHARMACY, INC. |
| Entity Type | Organization |
| Authorized Contact | CHAD KODIAK President 815-727-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054017695) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-09-27 |