Organization
NUDAK VENTURES LLC
Active
Other names
NuCara Pharmacy Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WILLIS (ACQUISITIONS MANAGER)
(641) 366-3440
Entity
Organization
Contact information
Practice address
101 W VALLETTE ST, ELMHURST, IL 60126-4419
(630) 834-1260
(630) 834-3166
Mailing address
PO BOX 640, CONRAD, IA 50621-0640
(641) 366-3440
(641) 366-3442
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
54.018039
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138301
PK
—
Enumeration date
05/14/2007
Last updated
03/29/2016
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