| NPI | 1881058543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUNJAN SHAH Pharmacy Manager 773-687-4513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 054.018094) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |