| NPI | 1740392687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHANSHYAM PATEL In Charge Owner 773-768-7868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: IL 054014973) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-04-30 |