| NPI | 1649226036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SCHREINER Manager Plan Implementation 847-916-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT 1606) |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2009-03-25 |