| NPI | 1942084538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ANDERSON VP CFO 815-971-6752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2024-08-13 |