| NPI | 1932155959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENZO TORRES New Store Enrollments 847-916-4463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT 1876) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-11-21 |