| NPI | 1366070476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY LINN RUIZ Pharmacist In Charge 217-679-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2021-02-24 |