| NPI | 1285954545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENNY KURUP Dir Of Pharmacy/Secretary 312-624-9397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054-017440) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2016-03-18 |