| NPI | 1255415386 |
|---|---|
| Doing Business As | 111TH PHARMA FAMILY |
| Entity Type | Organization |
| Authorized Contact | ADELE VANJACKSON PIC 773-785-5192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054018137) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-08-27 |