| NPI | 1588613384 |
|---|---|
| Doing Business As | DALES SOUTHLAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DALE COLEE President 217-429-5165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 54.015385) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2021-10-21 |