NPI | 1306894787 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC SCOTT BANDY Owner R Ph 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 | 2024-06-12 |