| NPI | 1952686032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOHMER Secretary 224-231-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: FL PH25710) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2024-01-18 |