| NPI | 1285970574 |
|---|---|
| Doing Business As | BELLEVUE PHARMACY OF ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | KEN SMITH Pharmacist In Charge 314-498-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-14 |