| NPI | 1578741872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: WV SP0552369) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2024-01-26 |