NPI | 1700014446 |
---|---|
Doing Business As | EXTENDED PHARMACY LLC |
Entity Type | Organization |
Authorized Contact | ERIC SPIRES Manager 309-676-4831 |
Organization Subpart ? | No |
Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IL 054016704) |
Additional Taxonomies | 333600000X Pharmacy (Licence: IN 64002202a) |
3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MO 2015044792) | |
Enumeration Date | 2009-07-01 |
Last Update Date | 2023-03-14 |