| NPI | 1669527677 |
|---|---|
| Doing Business As | NISSAN FAMILY PHARMACY #12952 |
| Entity Type | Organization |
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 05763 0.26) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-04-08 |