| NPI | 1346372372 |
|---|---|
| Doing Business As | INGALLS PROOF PHCY |
| Entity Type | Organization |
| Authorized Contact | RONALD RUTKOWSKI Pharmacy Manager 815-703-8434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054016131) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2010-02-04 |