| NPI | 1407867906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON EUGENE ANDERSEN President 618-377-5356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IL 054014647) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-03-07 |