| NPI | 1740662949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HARLOW Pharmacist In Charge 309-243-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054.019361) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |