A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers |
| NPI # | 1447265053 |
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| LBN Legal business name | CHICAGO MONTICELLO MEDICAL CTR | ||||||||
| Authorized official | MICHAEL EARLEY - (MD) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 07/30/2006 | ||||||||
| Last updated | 11/19/2007 - About 19 years ago | ||||||||
| Identifiers |
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