| NPI | 1861725913 |
|---|---|
| Doing Business As | COUSHATTA FAMILY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KERMIT R CRAWFORD Senior Vice President 847-914-3154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 6189) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-10-27 |