| NPI | 1760379465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAEN QATOUM Pharmacist In Charge 217-201-4726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-07-29 |