| NPI | 1568894749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD BLEICHMAN PIC Pharmacist In Charge 708-564-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054.020460) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054018074) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2018-07-18 |