| NPI | 1679856520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MI 5315052627) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2024-01-17 |