| NPI | 1770687782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD M JOHNSTON President 618-398-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054009963) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IL 054009963) | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |