| NPI | 1598040271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA SWEETEN Manager 217-709-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5302027870) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2018-05-09 |