| NPI | 1912171208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERMIT R CRAWFORD President 847-315-3154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 01049/01.1) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MS 01049/01.1) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2012-12-26 |