| NPI | 1841270386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDERJIT S RAKALLA President 217-446-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054009124) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2012-08-10 |