| NPI | 1841513165 |
|---|---|
| Doing Business As | ELECTRIC BOAT FAMILY PHARMACY #16491 |
| Entity Type | Organization |
| Authorized Contact | KIRA TAYLOR Manager 217-709-2351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CT PCY.0002155) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2022-05-06 |