| NPI | 1528468113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DOUGLAS CEO 815-404-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: GA PHRE010080) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2022-06-28 |