| NPI | 1518844380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |