| NPI | 1265509418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN ROBERT SLEDGE Pharmacist In Charge 773-265-3585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 093011593) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |