| NPI | 1255523155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y005085) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: AZ Y005085) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-01-26 |