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Organization
MOON LAKE PHARMACY, INC.
Active
Organization
MOON LAKE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC YANOW R.PH. (PRESIDENT)
(847) 895-3900
Entity
Organization
Contact information
Practice address
1399 W SCHAUMBURG RD, SCHAUMBURG, IL 60194-4134
(847) 895-3900
Mailing address
1399 W SCHAUMBURG RD, SCHAUMBURG, IL 60194-4134
(847) 895-3900
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
IL
Other
Enumeration date
05/24/2005
Last updated
08/22/2020
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