| NPI | 1639508567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TARANTINO Medical Director 309-692-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: IL 054-017718) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2021-07-30 |