NPI | 1487717898 |
---|---|
Former Legal Business Name | 1ST AVENUE PHARMACY INC. |
Entity Type | Organization |
Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2006-12-18 |
Last Update Date | 2024-05-21 |