| NPI | 1992049662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMAN ALANFOUS President 773-435-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054.018025) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 054.018025) |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: IL 054.018025) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies (Licence: IL 054.018025) | |
| 333600000X Pharmacy (Licence: IL 054.018025) | |
| 3336C0004X Pharmacy Compounding Pharmacy (Licence: IL 054.018025) | |
| 335G00000X Medical Foods Supplier (Licence: IL 054.018025) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2014-07-30 |