| NPI | 1255142311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDERJIT S RAKALLA Owner/PIC 217-446-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-01-22 |