| NPI | 1689974313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN T NIELSEN Treasurer 847-315-3523 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054-0017484) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2018-04-09 |