| NPI | 1619536240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMYAR GHAZVINI Pharmacist In Charge 224-294-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2019-10-07 |