| NPI | 1306894787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SCOTT BANDY Owner Rph 618-548-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 054008418) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-05-31 |