| NPI | 1821166067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVINCHANDRA SHAH Rphowner 773-533-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054009337) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2015-03-13 |