| NPI | 1316282163 |
|---|---|
| Doing Business As | GOOD SAMARITAN PLAZA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MICHELL R. ELLIS Pharmacist In Charge 618-899-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054.018065) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2013-02-28 |