| NPI | 1831274513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY BRUNER Owner 847-526-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: IL 054006291) |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2011-11-07 |