| NPI | 1891720314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D PRITZ Owner /Manager 815-723-0611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: IL 054006443) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: IL 054006443) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-09-27 |