| NPI | 1306771977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DONNELLE SPARKS Administrator 312-937-7814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2026-06-16 |
| Last Update Date | 2026-06-22 |