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 |