| NPI | 1659698496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DOUGLAS CEO 815-404-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: OH PMY.022050900-03) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2022-06-28 |