| NPI | 1306102728 |
|---|---|
| Doing Business As | PROPHARM RX INC |
| Entity Type | Organization |
| Authorized Contact | MAURICE SULLIVAN Sec/Tres 217-839-2909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-11 |