| NPI | 1528343381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAND MEHTA Pharmacy Manager 708-224-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: IL 051.292472) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |