| NPI | 1336282276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE GENE WILKS Owner 618-244-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054008911) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-06-25 |