| NPI | 1710153093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MO 2009030347) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2024-01-29 |