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CRUSADER CLINIC PHARMACY

Medical Equipment Supplier Yellow Pages

Rockford, Illinois

Provider NPI: 1215086442

Organization Information:
Organization Name:  CRUSADER CLINIC PHARMACY


Practice Location:
1100 BROADWAY  ROCKFORD, IL 61104 US
Tel: 815-490-1600  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0002XSuppliers
Pharmacy
Clinic Pharmacy
IL=========

Other Provider Identifiers:

IssuerNumberStateType
STATE LICENSE054-14089IL01
NABP1467580IL01
STATE CS032-006837IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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