| NPI | 1841500956 |
|---|---|
| Doing Business As | FANTUS HEALTH CENTER REFILL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHN JAY SHANNON Chief Executive Officer 312-864-6820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054.017503) |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2015-07-20 |