| NPI | 1215445085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2023-03-24 |