| NPI | 1700014446 |
|---|---|
| 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 |