NPI | 1295209443 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK DUANE EVARD VP Of Revenue Cycle 217-492-9651 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2019-01-21 |
Last Update Date | 2023-09-19 |