| NPI | 1578868360 |
|---|---|
| Doing Business As | PRAIRIE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANN ROHDE President 217-412-4408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054017639) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-03-24 |