NPI | 1215262134 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MN 263425) |
Additional Taxonomies | 333600000X Pharmacy (Licence: MN 263425) |
332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 263425) | |
Enumeration Date | 2009-10-09 |
Last Update Date | 2024-01-25 |