| NPI | 1851463087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PONCE Manager 847-527-2489 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 14412) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy (Licence: TX 14412) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2024-12-04 |