| NPI | 1609806983 |
|---|---|
| Doing Business As | MARTIN AVENUE PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | THOMAS MARKS President 630-355-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054004976) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-07-11 |