Organization
CHANNAHON RANCH PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS B KADUCAK (PRESIDENT)
(815) 467-6090
Entity
Organization
Contact information
Practice address
24715 W EAMES ST, CHANNAHON, IL 60410-5192
(815) 467-6090
(815) 467-6167
Mailing address
24715 W EAMES ST, CHANNAHON, IL 60410-5192
(815) 467-6090
(815) 467-6167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
054004856
IL
Other
Enumeration date
07/05/2006
Last updated
07/17/2012
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