Organization
BOLAD INC
Active
Other names
PETRANEK'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU S DIAB RPH FACVP (PRESIDENT)
(847) 362-2005
Entity
Organization
Contact information
Practice address
426 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-2248
(847) 362-2005
(847) 362-1304
Mailing address
426 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-2248
(847) 362-2005
(847) 362-1304
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051287521
IL
Other
Enumeration date
01/19/2007
Last updated
06/19/2008
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