| NPI | 1770828212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: NC 12587) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2023-03-29 |