| NPI | 1720162860 |
|---|---|
| Doing Business As | MED-X DRUG #15 |
| Entity Type | Organization |
| Authorized Contact | ALAN NIELSEN Treasurer 847-315-3523 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 22997) |
| 333600000X Pharmacy (Licence: OK 22997) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-04-05 |