| NPI | 1902918840 |
|---|---|
| Doing Business As | COPPER BEND PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | STEPHEN CLEMENT President 618-234-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054008430) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-12-08 |